Is MDMA neurotoxic?

MDMA (methylenedioxymethamphetamine), commonly known as ecstasy, does not appear to be neurotoxic when it is pure and used in appropriate dosages. This conclusion is partly based on a major study that was wrongly retracted because it mistakenly used methamphetamine instead of MDMA, an error that significantly distorted the outcomes regarding neurotoxicity 1.

However, it's important to note that the potential for neurotoxicity still exists with MDMA, especially under certain conditions. The risk appears to increase when MDMA is taken in high doses, frequently, or in combination with other drugs. Environmental conditions that lead to an increase in body temperature or blood pressure, such as dancing for long periods in hot environments, can also enhance the risks of neurotoxicity 2 3. Additionally, interaction with substances like caffeine might increase MDMA's toxicity due to effects on dopamine receptors 4.

Therefore, while lower doses and infrequent use of pure MDMA do not generally show neurotoxic effects, higher doses or unpure products combined with certain physical and drug-related conditions can pose significant risks 5.