the Aftermath of Ecstasy: Symptoms and Recovery - Psychiatry

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What are the side effects of ecstasy?


I am a patient who accidentally ingested ecstasy.
On April 20th of this year, I first consumed ecstasy, initially taking two pills, after which I lost consciousness for two hours.
I then took another pill, and subsequently experienced physiological symptoms such as palpitations, increased heart rate, sweating, body tremors, and chills (possibly due to amphetamines).
Psychologically, I experienced anxiety, depression, and paranoia.
These symptoms lasted for two weeks, after which I fully recovered.
However, a month later, at the end of May, I began to feel very dizzy.
After drinking a large cup of coffee in early July, I felt like I was going insane, suddenly unable to control my emotions.
I immediately sought treatment at the Poison Control Center at the Veterans General Hospital, where the doctor indicated that the drugs had affected my hypothalamus.
I was prescribed XANAX (Alprazolam) at half a tablet twice daily and CEPHENDOL (an anti-vertigo medication) at one tablet daily.
I have been on medication for three months now, and my dizziness has gradually improved, and I no longer need to take CEPHENDOL.
Since taking ecstasy, I have never experienced symptoms such as auditory hallucinations, visual hallucinations, delusions, or paranoid delusions.
I would like to ask: 1.
Are my symptoms indicative of acute amphetamine toxicity, considering that ecstasy often contains impure substances? 2.
I feel that my memory has worsened; does taking ecstasy even once cause memory impairment? 3.
If I stop taking XANAX, I will experience anxiety symptoms; how long will it take for these symptoms to improve?

Xiao Rui, 20~29 year old female. Ask Date: 2003/10/25

Dr. Tang Xinbei reply Psychiatry


Dear Xiao Rui,
Many young individuals, like yourself, have previously misused or accidentally ingested ecstasy.
Are your symptoms indicative of acute amphetamine toxicity? Although ecstasy is classified as a substance similar to amphetamines, it possesses both central nervous system stimulant and hallucinogenic properties.
Its use can lead to hallucinations and a sense of detachment from reality, thus it is categorized as a hallucinogen.
The components of ecstasy may not be pure (it could be MDMA combined with caffeine, or MDMA mixed with ketamine, etc.), and the reactions to the drug can vary among individuals.
Therefore, your situation should be evaluated and diagnosed by a specialist for a more accurate determination.
Recent studies have shown that such substances can cause damage to brain cells, potentially affecting memory or leading to persistent hallucinations and delusions.
Recovery may require abstaining from the substance for over a year, and some individuals may never fully recover, becoming chronic psychiatric patients.
The medication you are currently using, Xanax, belongs to the short-acting and potent sedative class of benzodiazepines, which is inherently addictive.
If taken in large amounts over a long period, withdrawal symptoms may occur within two to three days after discontinuation, including anxiety, tremors, palpitations, elevated pulse and blood pressure, cold sweats, tinnitus, headaches, and severe insomnia, typically lasting one to two weeks.
I continue to emphasize the concept of "safe medication," which means avoiding substances of unknown origin.
If you are unwell, it is essential to seek diagnosis and prescriptions from a qualified physician, and to have medications dispensed by a licensed pharmacist, using them according to medical advice.
I recommend that you continue discussing your situation with your attending physician and receive the necessary treatment.
Wishing you peace and joy!

Reply Date: 2003/10/25

More Info


The aftermath of ecstasy (MDMA) use can lead to a variety of physical and psychological symptoms, as you've experienced. Let's break down your questions and provide a comprehensive understanding of your situation.

1. Acute Symptoms of Amphetamine Intoxication: Based on your description, it is likely that you experienced acute symptoms related to the use of ecstasy, which often contains amphetamines or similar substances. Symptoms such as palpitations, increased heart rate, sweating, tremors, and chills are consistent with stimulant intoxication. The psychological symptoms of anxiety, depression, and paranoia can also occur, especially with substances that affect serotonin levels in the brain. The fact that these symptoms persisted for two weeks suggests a significant impact on your neurochemistry, which can happen with the use of such substances.

2. Cognitive Effects and Memory: Regarding your concern about memory loss, research indicates that MDMA can affect cognitive functions, particularly with repeated use. While a single exposure may not lead to long-term memory impairment, it can still impact cognitive performance temporarily. The neurotoxic effects of MDMA on serotonin-producing neurons can lead to deficits in mood regulation and memory. However, many individuals experience recovery over time, especially with abstinence from the substance. Your experience of feeling that your memory has worsened could be related to the psychological effects of anxiety and depression, which can cloud cognitive functions.

3. Duration of Withdrawal Symptoms: As for your anxiety symptoms when not taking Xanax (Alprazolam), it is important to understand that benzodiazepines can lead to dependence, and withdrawal symptoms can occur when the medication is reduced or stopped. The duration of these symptoms can vary widely among individuals. Generally, withdrawal from benzodiazepines can last from a few days to several weeks, depending on the duration of use, dosage, and individual factors. It is crucial to work closely with your healthcare provider to taper off the medication safely, as abrupt discontinuation can lead to increased anxiety and other withdrawal symptoms.


Additional Considerations for Recovery
- Psychotherapy: Engaging in cognitive-behavioral therapy (CBT) or other forms of psychotherapy can be beneficial in addressing anxiety, depression, and any cognitive concerns you may have. Therapy can provide coping strategies and support as you navigate your recovery.

- Lifestyle Modifications: Incorporating regular physical activity, a balanced diet, and adequate sleep can significantly improve your mental health and cognitive function. Exercise, in particular, has been shown to enhance mood and reduce anxiety.

- Support Systems: Surrounding yourself with supportive friends and family can help you cope with the emotional aftermath of your experience. Support groups for individuals recovering from substance use can also provide a sense of community and understanding.

- Monitoring Symptoms: Keep track of your symptoms and communicate openly with your healthcare provider about any changes. This will help them adjust your treatment plan as necessary.

In conclusion, while the acute effects of ecstasy can be distressing and lead to significant psychological symptoms, many individuals do recover over time with appropriate support and treatment. It is essential to continue working with your healthcare provider to manage your symptoms and to consider both pharmacological and non-pharmacological approaches to support your recovery.

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