MDMA (Ecstasy) Withdrawal Symptoms, Effects, and Timeline

Ecstasy, also referred to as MDMA, Molly, or X, is classified as a stimulant and a hallucinogen by the Drug Enforcement Administration (DEA).¹ It is a Schedule I drug with no currently accepted medical uses and a high risk for abuse.¹ Molly is commonly misperceived to be pure MDMA, but capsules of Molly may contain other drugs.²

Ecstasy withdrawal symptoms can occur after the drug’s effects wear off, usually between 3-6 hours, and the effects can last for a week or longer in some cases.^{1, 2,3} Withdrawal symptoms are rarely life-threatening, but they can be uncomfortable and distressing. The characteristics of Ecstasy withdrawal may be affected by the use of other drugs with MDMA.^{2, 3}

How Long Does Ecstasy Stay in Your System?

Once a person takes a dose of MDMA/Ecstasy, they may feel the effects approximately 30-45 minutes later, and they generally last between 3-6 hours.^{1, 2} It is not uncommon for users to pair MDMA with other drugs, such as LSD or marijuana, to enhance and lengthen the effects.^{1, 2,3}

Some people will take more than one dose or take additional doses over a period of time. Certain MDMA break-down products inhibit efficient processing of the drug, meaning that additional doses can lead to dangerously high concentrations.³

Even after the drug has worn off, people may continue to experience MDMA after-effects for a week or longer.^{1, 2, 3}

Symptoms and Effects of MDMA

Withdrawal symptoms for Molly or Ecstasy involve physical and psychological effects, including:

• Aggression.^{2, 3}
• Anxiety.^{2, 3}
• Decreased libido and pleasure from sexual activity.^{2, 3}
• Depression.^{2, 3, 4}
• Difficulty focusing or concentrating.⁴
• Fatigue.⁴
• Impulsivity.^{2, 3}
• Increased irritability.^{2, 3}
• Thirst.³
• Issues with memory.²
• Poor appetite.^{2, 3, 4}
• Sleep difficulty.^{2, 3}

Coming down from Ecstasy can be affected by a variety of factors. These include:

• The amount used.
• How long it has been used.
• Any other psychiatric or medical conditions.
• The use of other drugs, such as alcohol or marijuana.

Identifying MDMA withdrawal symptoms can be complicated by the fact that other substances or combinations of substances can be present in what is sold as “pure” Ecstasy. These can include methamphetamine, cocaine, ketamine, dextromethorphan, caffeine, ephedrine, and bath salts.^{1, 2} Since Molly is not produced in regulated laboratories, most consumers are not aware of what additional substances may be in the pills they are using.

Length of Withdrawal from MDMA

It can be difficult to pinpoint a specific Ecstasy withdrawal timeline due to the number of factors involved in coming down from MDMA. The use of other drugs, length of use, dose taken, presence of any adulterants in the Ecstasy, and medical or mental health issues can strongly influence the severity and length of withdrawal symptoms.

As the Ecstasy dose wears off, users may experience withdrawal symptoms within 3-6 hours of use, and these may peak over the first few days.^{1, 2, 3} The withdrawal timeline can include symptoms lasting up to a week or even longer in some cases.^{1, 2, 3}

The symptoms listed above tend to dissipate slowly over the first week of sobriety, though users may feel certain symptoms for longer, such as confusion, depression, and issues with concentration, memory, and sleep.⁴ Symptoms such as agitation, sleep disturbances, irritability, thirst, poor appetite, and restlessness generally resolve within a week.³

Is Withdrawal Dangerous?

Withdrawal from MDMA is not as risky as withdrawal from some other substances, such as alcohol or benzodiazepines, which can be life-threatening. However, complications of Ecstasy or Molly withdrawal can include:

• Anxiety. Withdrawal can cause anxiety, which can lead individuals to abuse other substances to relieve the anxiety.
• Depression. People who are withdrawing from Ecstasy or Molly may experience feelings of sadness or even extreme depression. Those experiencing severe depression are at risk for suicidal thoughts or behaviors.
• Decreased appetite. MDMA withdrawal can lead to reduced appetite, which may lead to some unhealthy weight loss and temporary nutritional deficiencies.
• Insomnia. Users that develop insomnia from withdrawal may be at risk of accidents or injury.

MDMA and Molly increase the activity of dopamine, norepinephrine, and serotonin.² These brain chemicals cause heightened energy and activity, euphoric feelings, raised heart rate and blood pressure, and changes in mood, appetite, sleep cycles, arousal, trust, and empathy.²

Treatment for MDMA Withdrawal or Addiction

Following Ecstasy use, the brain becomes depleted of serotonin, which can lead to disturbances in mood, sleep, and appetite.³ Those in withdrawal may be at a risk of relapse to avoid these uncomfortable or distressing symptoms.

The safest way to detox from MDMA is to find a detox program, an inpatient rehab facility, or outpatient rehab. Specialized medical and psychiatric staff in these programs monitor the safety and comfort of each person. Staff members are trained to identify symptoms, and they can provide support, treatment, and medication to ease the withdrawal process.