MDMA, commonly Ecstasy.

Classified under table 1 by Italian Misuse of Drugs Act (DPR 309/90)

Ecstasy (MDMA) and similar substances are atypical, empathogenic or entactogenic amphetamines, because they act on the mood, making feel at ease, sociable and agreeable.

MDMA stimulates the release of monoamines (dopamine, norepinephrine and serotonin) and blocks their reuptake.

Both activities increase their active level in the brain. MDMA acts directly on serotonin receptors, determining psychedelic effects.

MDMA is a powder, usually sold as tablets. On the tablets, a logo distinguishes the producer (White Doves, Yellow Superman, Apples, Pink Hexagons). Tablets are ingested.

As a powder it is wrapped in cigarette papers and swallowed up (“bomb” or “parachute”).

The dose is 100 mg.

Ecstasy tablets always contain mixtures of different entactogenic and stimulating substances. Effects vary widely from formulation and dosages. MDMA has the most intense entactogenic action compared to the other substances that are co-formulated in the tablet, generally having stronger stimulating action.

Available tablets can contain from 0 mg to 270 mg of MDMA, laced with PMA, PMMA and caffeine.

Substances having similar action:
MDA, MDEA, MBDB, PMMA, benzofuran, cathinones.

Ecstasy generally contains a mixture of entactogenic substances whose action lies between the stimulants and hallucinogens, giving alteration of the mood, with a better sense of acceptance of oneself and consciousness (leading to euphoria and intense sense of love of oneself and others), and a better sensations.

Ecstasy tablets always contain mixtures of entactogenic and stimulating substances. The effects vary greatly from formulation and dosages. MDMA has the most intense entactogenic action compared to lacing substances (usually stronger stimulants) co-formulated in the tablets.
Ecstasy reduces inhibition and makes tactile sensations more acute. Erection problems or delayed orgasm are frequent. Viagra or other erection stimulants are used together with ecstasy, what increases side effects of these drugs on heart and circulation (increased cardiac rhythm, increased pressure).

Increased body temperature, with abundant sweating. Thirst can lead to drink too much water Be careful to the quantity of liquids you are assuming.


Dry mouth, increased heartbeat.


Attention to excessive redness and rigidity, they are signs of intoxication.


The harms of prolonged use are poorly studied, because MDMA is a “weekend drug” and its effects turn bland for the habitual consumer, who shifts to other substances.


Neurotoxicity is more connected to stress during the acute intoxication than to persistence of an alteration of the serotonin system. Habitual users may have memory and learning problems.

Given the long lapse of time between two sessions (weekend drug), dependence does not seem to appear. Dependence is usually due to the lacing substances present into ecstasy tablets.
MDMA is very frequently taken together with other stimulants, laced in tablets and unknow to the user.

Associated use of cocaine increases the risk of serious anxiety. All stimulants increase MDMA toxicity, particularly if PMMA and PMA are present into the tablet.

Substances with sedative action, such as alcohol, GHB/GBL and opiates can mask ecstasy intoxication signs and result in difficult intervention by emergency departments.

Increased toxicity of MDMA in association with prescription drugs as:

amiodarone, citalopram, codeine, fluoxetine, haloperidol, methadone, paroxetine, valproic acid.

Ecstasy tablets never contain the same quantity of MDMA. The substance is never pure and the substances in association (especially PMA and PMMA) are more toxic and they last longer to take effect;


You have to try a quarter or half of a tablet to test for adverse effects. Taking more than one tablet at once does not increase the desired effects, but it worsens the toxicity;


You have to take regular breaks from dancing or from very intense physical activities to avoid exhaustion and overheating;


Hydration should be maintained because of excessive sweating, but never drink more than half a liter per hour to avoid excessive dilution of organic liquids;


Drinking alcohol and mixing with other substances increase risks of toxicity, masking its signs;


Serotoninergic syndrome risk is high. Call an ambulance if, after taking ecstasy, they are looking very hot and rigid;


You should avoid the use of ecstasy if you are on antidepressants.