• Depression
• Intense anxiety
• Exaggerated sense of love and intimacy
• Loss of inhibitions, leading to risky behaviour
• Confusion and paranoia
• Mood swings
• Impaired judgement which can lead to accidents
• Auditory or visual hallucinations (hearing or seeing things that aren’t real)
• Defensiveness
• Inability to focus or concentrate at work, home, or in any other areas of your life, as taking MDMA/ecstasy has become your main priority
• Diminished self-esteem and self-worth
• Consuming MDMA/ecstasy in order to relieve stress; this can often be the trigger for many people who go on to become addicted to MDMA/ecstasy
• Exacerbation of any existing mental health problems such as depression, anxiety or stress
• Suicidal thoughts and self-harm tendencies

• Frequent use of ecstasy in everyday life, not just when attending a party or club
• Taking the ecstasy via different methods, or mixing this with lots of different drugs, in order to experience a better high
• Taking MDMA becomes more important than engaging in activities that you once enjoyed
• Engaging in increasingly risky behaviours when under the influence of MDMA
• Feeling as though you want to stop taking MDMA, but finding that you are unable to
• Friends and family have noticed dramatic changes in your appearance and behaviour
• Neglecting responsibilities due to being high on ecstasy, or experiencing a ‘comedown’
• Inability to stop thinking about when, where and how you will get your next MDMA fix, and feeling as though this is taking over your life
• Being secretive and defensive about your use of MDMA
• Avoiding contact with loved ones, leading to social isolation
• Finding that you only tend to socialise with people who take ecstasy or other drugs
• Devoting an excessive amount of time to obtaining and using MDMA/ecstasy
• Poor performance and/or attendance at work
• Only spending time with other people who take ecstasy or other drugs
• Stealing money or selling valuables in order to obtain the money to buy MDMA/ecstasy
• Continuing to take MDMA/ecstasy even after suffering negative consequences as a result e.g. financial problems, social isolation, impaired work performance

• Finding that you have built a tolerance to ecstasy, meaning that you need to take higher doses on a more frequent basis, in order to experience the desired effects
• Disrupted sleep patterns, including insomnia
• Nausea and vomiting
• Muscle cramps and tension
• Feeling faint and dizzy
• Teeth clenching and grinding
• Dilated pupils
• Headaches
• Blurred vision
• Palpitations and heart arrhythmia
• Severe dehydration which can lead to hospitalisation
• Intense thirst leading to over-hydration (drinking too much water), which can cause brain swelling, brain damage and even death
• Seizures

Whilst there is little research examining the long-term effects of ecstasy use on the human brain and body, early trials suggest that using this drug in large quantities may eventually result in:

• Permanent brain damage affecting your behaviours, thoughts, sleep, emotions and learning
• A reduction in your brain’s ability to produce serotonin and dopamine, resulting in feeling low in mood and being unable to experience pleasure when you are not using MDMA/ecstasy
• Long-term depression, anxiety and memory loss
• Schizophrenia and drug-induced psychosis
• Kidney failure due to chemical poisoning and frequent dehydration
• Internal haemorrhaging of the brain and organs
• Heart damage and cardiovascular collapse resulting from pressure to arteries, vessels and valves
• Convulsions and seizures
• Respiratory arrest
• Heart attack

Whilst evidence suggests that MDMA is not physically addictive, people have reported experiencing a range of psychological withdrawal symptoms when they stop taking ecstasy. Psychological symptoms of MDMA withdrawal may include:

• Severe depression
• Acute anxiety
• Irritability
• Impatience
• Lack of concentration
• Memory loss
• Aggressive behaviour
• Anger
• Panic attacks
• Anxiety attacks
• Paranoia
• Confusion
• Auditory and visual hallucinations