Side Effects of Molly

Molly may have an innocent-enough sounding name, but this synthetic drug is guilty of having both stimulant and hallucinogenic properties. How long does Molly last in the human body and what are the after-effects of using Molly are questions that many misusers of the drug may have.

It’s often sold as a powder-filled capsule, and this form of 3,4-methylenedioxy-methamphetamine (MDMA/ecstasy) is supposedly the “purest” form of MDMA; however, Molly capsules often contain adulterant substances and, in some cases, may contain no MDMA at all.1

When ecstasy developed a reputation for being all-too-often adulterated with other substances and fillers, Molly was promoted by drug sellers as a safer, more pure form of MDMA. Researchers have found, however, that Molly is rarely pure and, even if it were pure MDMA, it still has the potential to harm those who use it.1

Brain Changes from Molly

Brain Changes from Molly (Neurotransmitters in the brain)Most of Molly’s effects are thought to primarily result from increases in the activity of 3 neurotransmitters in the brain:1

  • Serotonin.
  • Dopamine.
  • Norepinephrine.

Dopamine release is associated with pleasurable feelings and the reinforcement of behaviors that led to them. Molly’s influence on this neurotransmitter can increase feelings of energy, reward, and happiness and motivate repeated use.Increased activity of norepinephrine can raise blood pressure and heart rate.1

Many of Molly’s effects (both desirable and unwanted) are said to be the result of its influence on the serotonin system, which is involved with regulating not just mood, but sexual behavior, aggression, sensitivity to pain, sleep, and memory.1,2

Most often, users will ingest Molly orally. Many people begin to feel a euphoric high in about 20 to 40 minutes, with effects peaking in intensity within approximately 90 minutes of ingestion.3

High On Ecstasy or Molly: How MDMA Makes One Feel

The high from ecstasy, or Molly, is often characterized by effects such as:1

  • Elevated mood.
  • Increased sense of alertness.
  • Heightened energy.
  • Enhanced sense of physical touch.

Most notably, Molly is associated with heightened feelings of love, trust, empathy, and sexual desire. This may be due to the increased serotonin activity that Molly initiates throughout specific brain systems.The effects brought on by Molly typically last between 3 and 6 hours.1

Adverse Physical Health Effects

While the ecstasy high may bring on feelings of love and desire, not all the effects are so pleasurable. A person can experience numerous adverse effects while intoxicated by MDMA. These effects include:2,3

  • Blurry vision.
  • Abnormal eye movements (nystagmus).
  • Nausea/vomiting.
  • Hypertension (high blood pressure).
  • Rapid pulse and breathing rates.
  • Tense muscles.
  • Jaw and/or teeth clenching.
  • Chills.
  • Sweating.
  • Hyperthermia (especially when dancing) which may result in life-threatening problems with the kidneys, heart, or liver.
  • Heat exhaustion or heat stroke.
  • Severe dehydration (increased risk when alcohol is consumed in combination with Molly).
  • Electrolyte imbalances from excessive water consumption to combat dehydration.

Molly Comedown: The Next Day

As Molly wears off, the user may experience effects such as:1

  • Feelings of depression.
  • Anxiety.
  • Irritability and aggression.
  • Impulsivity.
  • Loss of appetite.
  • Insomnia.
  • Fatigue.
  • Memory problems.
  • Impaired ability to pay attention.
  • Loss of interest in sex.

The physical and psychological discomfort of a Molly comedown often leads people to take more of the drug—often in a binge pattern (close, repeated uses)—to combat these symptoms, a cycle that could lead to addiction.1

Some users describe the comedown from Molly as “suicide Tuesday” due to the associated anxiety and depression. Ecstasy use is particularly troubling in the adolescent population, as evidence has shown that young people who abuse ecstasy attempt suicide at higher rates than adolescents who use drugs other than MDMA or those who don’t use drugs at all.4

If you’re experiencing problems with Molly abuse, treatment can help you with the effects of a comedown and prevent further drug abuse. Greenhouse offers many levels of care for individuals struggling with a compulsion to use any drugs, including Molly.

What are the Long-Term Side Effects MDMA/Ecstasy?

Possible consequences of repeated MDMA use include:2,3,5

  • A relative depletion of serotonin in the brain.
  • Impulsive behaviors.
  • Aggression.
  • Cognitive impairment, including memory problems.
  • Disrupted sleep.
  • Anorexia.
  • Drug cravings.
  • Confusion.
  • Severe anxiety.
  • Paranoia.
  • Risky sexual behavior resulting in unwanted pregnancy or STDs.
  • Impaired ability to perform sexually.
  • Dental problems due to teeth clenching.

Lasting Effects on Serotonin

Many substances of abuse influence the activity of serotonin, but Molly is unique in the rapid changes to this neurotransmitter system its use results in, which may result in particularly long-lasting decreases in serotonin activity.6

Primates exposed only briefly to MDMA were shown to have a lowered number of serotonergic neurons 7 years later. Reduced serotonin is thought to play a role in the depression, anxiety, memory impairment, and confusion commonly seen wtih chronic users of MDMA.6

Overdose from Molly

Overdosing on Molly, ecstasy, or MDMA is possible. Even a “normal” dose of Molly could be too much, leading to acute health conditions including:1-3

  • Heat stroke.
  • Dangerous dehydration.
  • Heart damage.

Heat Stroke

One potentially lethal complication associated with MDMA use is heat stroke. MDMA-based drugs have been known to elevate body temperature up to 108 degrees Fahrenheit.3For adults, a body temperature around 100 degrees Fahrenheit is considered a fever while 103 is a high-grade fever; hyperpyrexia, or dangerously high fever, begins at 106 degrees.

When Molly elevates the core body temperature enough, serious adverse health events including muscle breakdown (rhabdomyolysis), failure of the kidneys, or even deadly brain swelling (often in women) have been reported.5


Hyponatremia may develop when Molly users attempt to counter dehydration by drinking a lot of water. The intake of too much water can essentially dilute electrolyte levels—leading to dangerously low serum sodium concentrations which could lead to numerous problems such as confusion, nausea, muscle cramps, seizures, and death.8

Why Get Help?

Molly may be a popular club drug, but the potential side effects are many and some, left untreated, may be fatal.5

Taking the drug just once can be deadly; if a person abuses Molly consistently, they may be at risk of developing persistent neurochemical changes that could lead to chronic depression and other mental health issues.2,3

Prolonged abstinence from Molly may lessen or reverse the negative effects of long-term use. If you struggle with an addiction to MDMA, a rehabilitation program can help you take the first step toward your recovery.

Greenhouse Treatment Center has the experienced and licensed medical staff to help patients undergo treatment specific to their needs. Together we can help you reach long-term sobriety while avoiding the dangers of an overdose and the pain from the after-effects of using Molly. If you or a loved one are seeking help for an addiction to Molly, visit our treatment overview to see how Greenhouse, or another American Addiction Centers location, can help support you.


  1. National Institute on Drug Abuse. (2018). MDMA/Ecstasy (Molly). 
  2. Scientific American. (n.d.). What are the effects of the drug Ecstasy? 
  3. Center for Substance Abuse Research. (2013). Ecstasy.
  4. Kim, J., Fan, B., Liu, X., Kerner, N., & Wu, P. (2011). Ecstasy use and suicidal behavior among adolescents: findings from a national surveySuicide & life-threatening behavior41(4), 435–444.
  5. National Institute on Drug Abuse. (2017). MDMA (Ecstasy) Abuse.
  6. National Institute on Drug Abuse. (2017). MDMA (Ecstasy) Abuse.
  7. emedicine health. (n.d.). Fever (in Adults)
  8. Mayo Clinic. (2018). Hyponatremia.

About The Contributor

Scot Thomas, M.D.
Scot Thomas, M.D.

Senior Medical Editor, American Addiction Centers

Dr. Thomas received his medical degree from the University of California, San Diego School of Medicine. During his medical studies, Dr. Thomas saw firsthand the multitude of lives impacted by struggles with substance abuse and addiction, motivating... Read More

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