What Does MDMA Do To Your Brain

What Does MDMA Do To Your Brain

MDMA remains one of the most popular recreational drugs in the world. Thanks to its unique chemical structure and the effects it produces, MDMA has captured the interest of research scientists and mainstream drug enthusiasts alike.

But what does MDMA do to the brain? What happens to the brain after an MDMA trip? Are there risks associated with regular use?

Read on to better understand what MDMA does to your brain.

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What Is MDMA?

3,4-Methylenedioxymethamphetamine (MDMA) is a synthetic drug that was first synthesized in 1912 by German pharmaceutical company Merck. It was not until the late 1970s that MDMA would be brought to a larger audience by the late renowned drug researcher and psychonaut Alexander Shulgin, where it was used by psychiatrists and therapists in largely underground experimental therapeutic settings.

By the late 1980s, MDMA had become a popular recreational drug in the burgeoning electronic music and rave scenes.

Today, MDMA remains one of the most popular recreational drugs used globally. According to the 2016 National Survey on Drug Use and Health, more than 18 million people in the United States have tried MDMA at least once in their lifetime.

In addition to its enduring popularity for recreational use, MDMA is currently undergoing clinical trials as a “breakthrough therapy” in treating conditions such as autism spectrum disorder and anxiety related to late stage cancer, for example. It is in the final stages of clinical research, and may gain approval from the Food and Drug Administration (FDA) for its use in treating PTSD.

Why Do People Use MDMA?

MDMA has gained traction in both therapeutic and recreational settings due largely to the experience it produces.

MDMA produces “prosocial” effects. This leads to people feeling much friendlier, and more empathetic or connected to others around them. It creates a sense of euphoria and well-being that heightens a person’s response to positive stimuli while decreasing a person’s response to negative stimuli. Due to these properties, many refer to MDMA as an “entactogen” or an “empathogen.”

MDMA also produces stimulating effects, such as increasing energy and curbing fatigue, while enhancing tactile experiences like touching, for example.

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What Does MDMA Do To The Brain?

The ways that MDMA impacts brain function are numerous, and not yet fully understood. Because of its illegal status in the U.S. and much of the world, scientific research on this compound has been historically hard to conduct.

We do understand that MDMA impacts the release of messenger chemicals in the brain called neurotransmitters. You’ve probably heard of neurotransmitters such as serotonin, for example, and MDMA produces much of its effects due to the way it impacts serotonin levels in the brain.

MDMA also impacts the neurotransmitters dopamine and norepinephrine. These neurotransmitters work together to impact a wide variety of our bodily functions:

  • Serotonin: Helps regulate mood and emotions. It is also helps regulate sleep, pain perception and appetite, among others
  • Dopamine: Involved in many central nervous system functions, in addition to being involved in the regulation of mood and the reward center of our brains. It also plays a role in memory and in our ability to focus and learn
  • Norepinephrine: This neurotransmitter is important to the fight-or-flight response. It also helps regulate mood, anxiety, sleep, energy, and focus

With the changes in the trio of neurotransmitters, MDMA produces the euphoric and altered state of consciousness.

“These effects are possible because when a person takes MDMA, serotonin, dopamine, and norepinephrine are all heightened in the brain,” explained Heather Wilson, LCSW, LCADC, CCT and Director at Epiphany Wellness. “The excess of these neurotransmitters, particularly serotonin, causes one’s mood to elevate.”

MDMA is able to both increase levels of these chemicals and delay their reuptake, thereby producing much higher levels than would normally be present in the brain. While there has been speculation as to whether MDMA’s ability to increase levels of “the love hormone” oxytocin is part of why it can produce the potent prosocial effects mentioned earlier, to date research has not been able to make a definite link between the two.

Newer research has suggested that MDMA’s ability to create prosocial and euphoric effects are due to two different mechanisms, with serotonin being more linked to the prosocial effects and dopamine to the rewarding or euphoric effects.

With that said, these neurotransmitters impact much more than just mood, and increases in them produce effects that go beyond euphoria and feelings of connection.

“Additionally, increased serotonergic activity in the brain can affect vision and eye movement, excitation of the facial muscles and produce cardiovascular effects,” said Dr. James Giordano, Professor of Neurology and Biochemistry, Georgetown University Medical Center.

He links these impacts to some of the more common side-effects associated with MDMA, including wobbly vision, jaw clenching and an increase in heart rate and blood pressure.

“Many of these effects are dose dependent, and significantly increase with higher doses and more frequent use,” he added.

MDMA’s effect on eye vision and movement may impact a person’s ability to perceive and predict motion accurately, both while on the drug and in the hours and days following the trip, which could in turn impact the ability to carry out complex and skilled activities like driving a car, for example. In addition, MDMA may make concentration more difficult while affecting memory, learning and general cognition.

MDMA seems to increase a person’s attention towards positive experiences — while decreasing the impact of or ability to recognize negative ones. That means it can both facilitate the type of work that is done to treat trauma in therapeutic settings, as well as lead to feelings of safety even in the face of potential hostility or danger.

Some data suggests that being under the influence of MDMA can lead to riskier behavior such as unsafe sex or mixing MDMA with other substances which can be dangerous.

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MDMA And The Brain: After The Trip

The MDMA experience typically lasts between three to six hours. During this time, the levels of serotonin, dopamine and norepinephrine elevate, thereby producing a variety of effects in the mind and body.

But what happens once the trip is over?

While some people experience an “afterglow effect” after an MDMA trip, where they continue to feel a heightened sense of happiness and well-being, it seems that these people are few and far between. It is common and completely normal to feel depressed and depleted for several days (or longer) after taking MDMA.

“Because the brain releases so much serotonin when you’re on MDMA, the brain’s supply of this neurotransmitter can be significantly depleted afterwards,” explained Wilson. “Serotonin is essential in the brain’s regulation of mood, sleep, pain, and appetite. This is why many users of MDMA report negative psychological effects days after taking the drug.”

In other words, it takes your brain some time to replenish serotonin levels and return to homeostasis.

“There is a period of time (hours to days) required for serotonin metabolism to return to normal and stabilize serotonin release and functionality within the brain,” said Dr. Giordano.

MDMA depletes serotonin levels and also “turns off” some of the serotonin receptors in the brain. So not only is there less serotonin available in the brain following an MDMA trip, but your brain might be less sensitive to it, too.

In one animal study, rats were given high doses of MDMA over the course of four days. Initially, observations showed a decrease in the number of serotonin receptors. By day 21, however, these levels had returned to normal.

Another study in primates showed that there were long-term impacts to serotonin receptors up to seven years after MDMA administration. Research has yet to fully understand the exact impact on human brains. But it is clear that MDMA impacts serotonin levels in the brain in the days following a trip.

“This too is dose related, with higher doses and more frequent dosing producing more long lasting effects,” said Dr. Giordano. “Characteristically, the effects of decreasing serotonergic function include lethargy, depressed mood, and rebound thirst.”

In the week following their MDMA trip, some people also reported impaired memory and ability to concentrate along with a lack of appetite and feelings of irritability and anxiety.

Long Term Use Of MDMA

Many people who take MDMA do so infrequently, for a specific party, gathering or therapeutic purpose. But what happens if you take MDMA regularly?

“While effects induced by low and infrequent dosing are mild and transient, higher and more frequent dosing of MDMA can produce more long lasting effects,” said Dr. Giordano.

If taking MDMA regularly without giving your body enough time to restore serotonin levels and functionality, you may become chronically depleted, which could lead to ongoing feelings of depression, tiredness and irritability, among other adverse effects.

“As well, more frequent use of MDMA can lead to an initial blunting of acute effects produced (a form of metabolic tolerance) so that individuals may feel the “need“ for higher or more doses of the drug to produce the desired effects,” said Giordano.

More high quality human clinical trials examining the long term effects of MDMA use are needed, but we do have some initial clues as to how MDMA might impact the brain with regular use.

In one survey of regular MDMA users, common negative effects reported included the development of tolerance to MDMA (59 percent), impaired ability to concentrate (38 percent), and depression (37 percent).

One study looked at a small group of Ecstasy users who had been taking the drug at least twice a month for the last two years. The results suggest that regular long term use of MDMA may cause impairment to memory, attention and a decline in general cognitive performance.

Other studies have supported these findings, suggesting that some people who take MDMA regularly may experience more confusion, depression, and paranoia, along with trouble with attention and memory. One study suggested that recreational MDMA users might develop higher levels of impulsivity associated with lower serotonin levels.

Long term MDMA use might also have impacts outside the brain.

In one animal study, researchers found that repeated MDMA doses over a short period of time (binging) produced changes in heartbeat (arrhythmia) and heart damage. Long term MDMA use may also have other impacts on the cardiovascular system such as valvular heart disease.

Is MDMA Neurotoxic?

Neurotoxicity can occur when exposure to natural or manmade toxic substances alters the regular activity of the nervous system. This can disrupt or even permanently damage neurons, which are key cells that transmit and process neurochemical signals in the brain and other parts of the nervous system.

Animal studies have shown that large or repeated doses of MDMA can damage serotonin axons, important brain structures that help transport serotonin’s signals throughout the brain. In addition, dopamine may contribute to neurotoxicity by increasing body temperature, which is a factor that determines whether neurotoxicity will occur. The evidence that MDMA produces neurotoxicity in human brains, however, is still inconclusive.

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What Does MDMA Do To The Brain – Conclusion

The MDMA experience is largely the result of dramatic increases in the levels of serotonin, dopamine and norepinephrine in the brain. These produce a variety of effects in the mind and body. MDMA is also known for its prosocial effects, which help users feel a strong sense of empathy and closeness to people around them — along with feelings of euphoria and well-being.

Thanks to the above effects, research continues to investigate if MDMA therapy can help treat PTSD, autism spectrum disorder and anxiety related to late stage cancer.

MDMA’s impacts to the brain can be minimal or transient with infrequent moderate doses. However, the long term impacts of regular use could include impacts to mood, memory and general cognition.

Overall, more human research is needed to understand both the long term impacts of regular MDMA use and whether it causes neurotoxicity. There is a growing body of evidence to support that the short term therapeutic use of MDMA can serve as a valuable tool in treating a variety of mental health concerns and, as of writing, the use of MDMA in psychedelic assisted therapy to treat post-traumatic stress disorder is expected to be approved by the FDA.

Lauren M. Wilson

Lauren M. Wilson

View all posts by Lauren M. Wilson

Lauren M. Wilson is a five-time published author, freelance writer and editor. She has built a career on investigating cultural niches and her latest works, including three books, have focused on advancing the mainstream conversation on cannabis through education. She is currently diving into the psychedelic renaissance and lives in Brooklyn, New York.

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