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Short-Term Side Effects of MDMA
by Erowid
v1.0,September 2001

See MDMA Effects for a more complete list of MDMA's effects, this article is focused on giving an overview of MDMA's (generally unwanted) side effects profile and is neither a complete list of possible side effects nor does it represent the full range of effects of MDMA.

Based on reports from users, common adverse side effects of MDMA ingestion include rise in blood pressure and heart rate, nystagmus (eye-wiggling), trismus (jaw tension), bruxia (teeth grinding), sweating, agitation, a post-peak crash, muscle tension, headaches, nausea & vomiting, dry-mouth, liver problems, water retention, fatigue, confusion, mood swings, black outs, etc. While these effects have been known for years, there hasn't been much data about the prevalence of these various side effects.

In January 2001, the first peer reviewed paper to have a good overview of the subjective side effects was published by Liechti, Gamma, and Vollenweider in the journal Psychopharmacology. Their paper was based on clinicial research conducted over several years involving 74 healthy volunteers.

The researchers found that there were a number of common side effects and that many of the effects seemed to occur in different amounts based on gender. The top side effects reported were Difficulty Concentrating, Jaw Clenching, Lack of Appetite, and Dry Mouth/Thirst (all occuring in more than 50% of the 74 volunteers).

Liechti et al summarize the adverse effects by saying "Adverse effects were more frequently reported by women compared to men and mainly included jaw clenching or increased tension in maxillary muscles, dry mouth, and lack or loss of appetite. Sweating and nausea were more frequent in men. At the onset of the MDMA effect some subjects reported nausea, hot flushes, paresthesia, and dizziness. Tremor and increased restlessness were observed in about one-third of the subjects. Side effects were generally considered mild and were similar to those reported in previous controlled studies (Vollenweider et al. 1998a) or by Ecstasy users (Peroutka et al. 1988; Solowij et al. 1992). There were no complications requiring medical intervention."

Numbers indicate percentage of all subjects under MDMA reporting a specific complaint. Numbers in parentheses indicate percentage of all subjects under placebo reporting a specific complaint.

 Acute Adverse Effects
MDMA (Placebo)
After Effects at 24 hrs after
MDMA (Placebo)
 All
n=74
Female
n=20
Male
n=54
All
n=74
Female
n=20
Male
n=54
Difficulty concentrating59 (15)75 (15)54 (15)28 (8)30 (10)28 (7)
Jaw clenching58 (0)65 (0)56 (0)20 (0)25 (0)19 (0)
Lack of appetite54 (4)75 (5)46 (4)39 (3)50 (0)35 (4)
Dry mouth/thirst53 (3)65 (5)48 (2)34 (4)60 (10)24 (2)
Impaired balance49 (0)50 (0)48 (0)7 (0)5 (0)7 (0)
Restless legs41 (1)40 (0)41 (2)11 (1)5 (0)13 (2)
Sensitivity to cold41 (11)50 (15)37 (9)12 (3)10 (10)13 (0)
Dizziness38 (1)40 (0)37 (2)7 (0)10 (0)6 (0)
Palpitations35 (1)50 (0)30 (2)7 (0)15 (0)4 (0)
Restlessness34 (1)35 (0)33 (2)12 (1)15 (5)11 (0)
Being cold34 (7)45 (15)30 (4)9 (3)20 (10)6 (0)
Sweating/sweaty palms31 (0)20 (0)35 (0)12 (0)5 (0)15 (0)
Forgetfulness28 (1)40 (5)24 (0)11 (1)10 (0)11 (2)
Heavy legs27 (1)50 (0)19 (2)12 (0)20 (0)9 (0)
Fatigue26 (47)35 (45)22 (48)41 (26)55 (25)35 (26)
Weakness26 (1)35 (5)22 (0)24 (1)35 (5)20 (0)
Hot flushes24 (3)40 (5)19 (2)15 (1)20 (5)13 (0)
Tremor23 (0)25 (0)22 (0)8 (0)10 (0)7 (0)
Paresthesia22 (9)25 (15)20 (7)1 (8)5 (10)0 (7)
Inner tension20 (5)15 (5)22 (6)8 (5)10 (5)7 (6)
Brooding16 (3)20 (0)15 (4)18 (1)20 (0)17 (2)
Nausea15 (3)10 (5)17 (2)1 (0)0 (0)2 (0)
Lack of energy15 (8)25 (10)11 (7)24 (4)40 (5)19 (4)
Exhaustibility15 (4)15 (10)15 (2)19 (1)30 (0)15 (2)
Frequent urge to urinate14 (5)10 (10)15 (4)15 (5)15 (10)15 (4)
Headache12 (12)15 (20)11 (9)27 (7)35 (10)24 (6)
Insomnia---24 (0)30 (0)22 (0)
Anxiety11 (1)15 (5)9 (0)1 (1)5 (0)0 (2)
Irritability8 (1)15 (5)6 (0)5 (0)15 (0)2 (0)
Increased appetite4 (7)0 (5)6 (7)1 (3)0 (0)2 (4)
Muscle aches1 (3)5 (5)0 (2)3 (3)5 (0)2 (4)
Bad dreams---7 (3)15 (5)4 (2)


There are also a variety of other less common side effects which have been reported by users. All psychoactives have a wide variety of idiosyncratic effects and psychedelics in general can cause nearly any type of symptom to manifest because they affect the mind, the general nervous-system, regulatory chemical systems, and one's perceptions. Less common side effects include hyper-salivation (uncontrollable, profuse saliva), paranoia, a profound sense of isolation & loneliness, psychotic episodes, extreme panic attacks, extreme depression, and a variety of other more mild mental/spiritual disruptions.

Physiological Effects of MDMA

Liechti et al also measured some of the test subjects for blood pressure, heart rate, and body temperature against a placebo control. The increases were noticeable, but not dangerous and not statistically significant for many of the readings (this means that the changes they measured were not certain to be an effect of the drug instead of random chance).

Liechti summarized the Physiological effects they measured, saying "MDMA increased heart rate in both genders by 13 beats/min compared to placebo, however, this was only significant in men. Similarly, peripheral body temperature was increased significantly by 0.4C compared to placebo in male subjects while MDMA-induced increases in body temperature did not reach statistical significance in female subjects. All body temperatures remained below 38C. There were no correlations between the dose per kilogram body weight and blood pressure or body temperature values."

 PlaceboMDMA
 nBaselinePeakBaselinePeak
Systolic blood pressure (mm Hg)Male54125 +/- 12124 +/- 13123 +/- 12157 +/- 21*, **
 Female20114 +/- 8112 +/- 10116 +/- 12138 +/- 14*, **
Diastolic blood pressure (mm Hg)Male5478 +/- 1180 +/- 1277 +/- 1195 +/- 14*
 Female2075 +/- 875 +/- 1076 +/- 1086 +/- 11*
Heart Rate (beats/min)Male3464 +/- 1060 +/- 864 +/- 1173 +/- 14*
 Female1167 +/- 1170 +/- 970 +/- 1483 +/- 15
Body Temperature (C)Male4436.6 +/- 0.336.5 +/- 0.336.6 +/- 0.436.9 +/- 0.4*
 Female1436.7 +/- 0.336.8 +/- 0.436.7 +/- 0.437 +/- 0.4
Body Temp translated into Fahrenheit (original in Celcius only)
Body Temperature (F)Male4497.9 +/- 0.597.7 +/- 0.597.8 +/- 0.798.4 +/- 0.7*
 Female1498.1 +/- 0.598.2 +/- 0.798.1 +/- 0.798.6 +/- 0.7

Notes:
The "n" column is the number of human subjects involved in the test.

*  P < 0.001, post hoc test for MDMA versus placebo based on significant drug main effect
** P < 0.05, significant drug x gender interaction

References:
Gender Differences in the Subjective Effects of MDMA,
Liechti ME, Gamma A, Vollenweider FX
Psychopharmacology, 2001; 154:161-168