Possible Scarless
Adverse effects
MDMA use has been shown to produce brain lesions, a form of brain damage, in the serotonergic neural pathways of humans and other animals.[2][4] In addition, long-term exposure to MDMA in humans has been shown to produce marked neurotoxicity in serotonergic axon terminals.[19][25][27] Neurotoxic damage to axon terminals has been shown to persist for more than two years.[27] Brain temperature during MDMA use is positively correlated with MDMA-induced neurotoxicity in animals.[19] Adverse neuroplastic changes to brain microvasculature and white matter also seem to occur in humans using low doses of MDMA.[19] Reduced gray matter density in certain brain structures has also been noted in human MDMA users.[19] In addition, MDMA has immunosuppressive effects in the periphery, but pro-inflammatory effects in the central nervous system.[28] Babies of mothers who used MDMA during pregnancy exhibit impaired motor function at 4 months of age, which may reflect either a delay in development or a persistent neurological deficit.[16][29]
MDMA also produces persistent cognitive impairments in human users.[1][15][16] Impairments in multiple aspects of cognition, including memory, visual processing, and sleep have been noted in humans;[15][16] the magnitude of these impairments is correlated with lifetime ecstasy or MDMA usage.[1][15][16] Memory is significantly impacted by ecstasy use, which is associated with marked impairments in all forms of memory (e.g., long-term, short-term, working).[15][16]
The most serious short-term physical health risks of MDMA are hyperthermia and dehydration.[25][30] Cases of life-threatening hyponatremia (excessively low sodium concentration in the blood) have developed in MDMA users attempting to prevent dehydration by consuming excessive amounts of water without replenishing electrolytes.[25][30][31]