MDMA (3,4-methylenedioxymethamphetamine) is an illegal drug that affects the mood. Other names for recreational MDMA include ecstasy, X, and Molly.

MDMA is a drug that alters a person’s mood by changing the release of chemicals in the body that affect mood and behavior.

Researchers are currently looking into the effects of pure MDMA on the brain to try to determine whether it could help treat depression.

Here, we look at the effects of MDMA on depression, as well as the potential therapeutic benefits of other recreational drugs. We also discuss the risks of using these drugs as treatments for mental health conditions.

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More research is necessary to understand the long-term effects of MDMA on the brain.

Researchers are looking into the potential use of MDMA within a clinical setting to improve mood and treat depression.

Effects of MDMA

MDMA causes an increase in the neurotransmitters dopamine, norepinephrine, and, in particular, serotonin. The rise in serotonin causes an elevation in mood.

One potential benefit of MDMA as an antidepressant treatment is how quickly it works to alter the mood.

Traditional depression medications, such as selective serotonin reuptake inhibitors (SSRIs), can take about 6 weeks to provide significant relief.

In contrast, MDMA may provide instant relief from depressive symptoms. A 2012 study looked at the immediate effects of MDMA in people with and without a predisposition to depression.

The study included 40 participants, with 20 people in the MDMA group and 20 in the control group. In people with a predisposition to depression, the consumption of MDMA caused a significant reduction in depressive symptoms.

However, researchers need further evidence to confirm the long-term antidepressant activity of MDMA.

Other mental health conditions

Research has found that, alongside psychotherapy, MDMA could be effective in the treatment of other mental health conditions, such as:

  • post-traumatic stress disorder (PTSD)
  • anxiety in association with a life threatening illness
  • social anxiety in autistic adults

MDMA may, therefore, also work to treat additional mental health conditions, including depression. It may provide benefits in people already using psychotherapy as a treatment.

Currently, researchers need more evidence to determine whether MDMA could be a safe and effective treatment for depression.

It is also vital to note that the MDMA that researchers use in clinical settings is free of the potentially harmful additives in the drugs that people purchase illegally.

MDMA affects the body’s levels of serotonin, a chemical that affects mood and behavior. Research has linked higher levels of serotonin to feelings of happiness and associated lower levels with a depressed mood.

During MDMA intoxication, serotonin levels increase, which can cause people to feel a greater sense of openness, well-being, and happiness.

However, after this initial increase, serotonin levels will decrease. This reduction in serotonin levels can cause a depressed mood in some people.

Risk of suicidal behavior

There is an association between reduced serotonin levels and suicidal behavior. A 2011 survey of 19,301 adolescents aged 12–17 in the United States revealed a link between ecstasy (MDMA) use and suicide attempts.

The researchers used data from the 2000 National Household Survey on Drug Abuse. They found that rates of suicide attempts among the adolescents who had taken MDMA in their lifetime were nearly double that of those who had taken drugs other than MDMA.

Suicide attempt rates among the adolescents who had taken MDMA were also nine times higher than in those who had never taken any illicit drugs.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects if it’s safe to do so.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Find more links and local resources.

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Serotonin toxicity

MDMA may increase feelings of distress in people with a history of mental illness. Taking MDMA alongside antidepressants can also cause dangerous side effects.

For instance, combining MDMA with some antidepressants may increase the risk of toxicity from an excess of serotonin. Symptoms include:

  • confusion
  • agitation
  • very high temperature
  • potential coma and death

In some cases, serotonin toxicity can even lead to coma or death.

Researchers are still looking into the long-term effects of MDMA use on the brain.

Other risks

According to the National Institute on Drug Abuse, heavy, long-term use of MDMA may cause issues with learning and memory.

Large doses of MDMA may cause damage to the brain and nervous system in animals. Researchers need to carry out large-scale human studies to determine whether smaller doses of MDMA are safe in humans.

Controlled trials with pure MDMA are also important to rule out other factors that could affect mood. The environment in which people take MDMA and other substances that the drug may contain might have an effect on how people react to it.

Ongoing research is also looking at the potential of other recreational drugs, such as psychedelics, to treat depression.

A 2016 study looked at the effects of psilocybin, a hallucinogenic substance in some types of mushrooms. A total of 12 participants with moderate-to-severe depression took part in the study.

The researchers gave each participant a 10-milligram (mg) and a 25-mg oral dose of psilocybin, 7 days apart.

There was a decrease in initial depression scores at 1 week and 3 months after treatment, with the biggest reduction taking place in the second week of the trial.

Eight of the 12 participants had complete remission in week one, and seven of these individuals had continued remission 3 months later. None of the participants experienced unexpected or serious side effects.

Although this evidence suggests that psilocybin has potential as a depression treatment, this was a small study with no control group. Researchers will need further evidence to support these findings.


Microdosing is the regular intake of very small amounts of psychedelics, such as lysergic acid diethylamide (LSD) and psilocybin. People who microdose often take a dose every 3 days.

Anecdotal reports suggest that microdosing can improve mood, social ability, and overall well-being. The participants in a 2019 study reported the effects of microdosing on their mood, rating their feelings of happiness and well-being.

Across a range of substances and doses, the study found that microdosing for 6 weeks improved mental health but also increased neuroticism.

There is no specific research on the safety of microdosing. Research into the safety of larger doses of psychedelics suggests that they are relatively safe and generally not addictive.

However, these drugs are illegal in most areas. Whereas the substances that researchers use are pure, those available to buy illegally may contain harmful ingredients.

People can see their doctor to find a depression treatment that works for them. Traditional depression treatments include:

  • psychotherapy, such as cognitive behavioral therapy (CBT)
  • medications, such as antidepressants and mood stabilizers
  • regular exercise
  • mindfulness and meditation
  • high quality sleep
  • stress reduction techniques and practices
  • brain stimulation therapies, such as electroconvulsive therapy
  • light therapy to regulate melatonin production

A combination of treatments may be most effective in treating depression.

People can work alongside a healthcare professional to develop a personalized treatment plan that is safe and effective for them.

MDMA is an illegal drug that people may take to elevate their mood and create a sense of well-being and happiness.

Ongoing research is looking into the effects of MDMA on the brain to determine whether it could be a treatment for depression.

MDMA increases the release of serotonin and other neurotransmitters that elevate the mood. After taking MDMA, these feel-good chemicals decrease, which can cause feelings of depression.

Controlled doses of pure MDMA with professional supervision may provide immediate relief for depression.

Researchers are still unsure of the long-term effects of MDMA on the brain, though. MDMA can produce harmful side effects in people, and it may have a negative effect on mental health and worsen existing depression.

Until further evidence leads to a clinically approved dose of MDMA for depression, people are safest using traditional treatment methods.