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Can MDMA Cause Anxiety?

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MDMA, also known as Molly, is a popular party drug that has never been approved for any medical uses. However, researchers are investigating its potential as a therapeutic drug, specifically, a drug used in the treatment of mood disorders like anxiety. However, some people that use it report feeling anxious and even paranoid. Is this drug an anxiety remedy or the cause of anxiety? The answer to that question can have an impact on whether this drug should be avoided by people that struggle with anxiety, or if doctors should pursue it as a helpful drug.

Learn more about MDMA and examine the scientific evidence behind its effects on anxiety.

What is MDMA?

MDMA, or Methylenedioxymethamphetamine, is a drug that can cause both stimulant and hallucinogenic effects. The drug was first synthesized in 1912 by a German chemist working for the Merck pharmaceutical company. MDMA was created as a byproduct when the company was trying to develop a medication to stop abnormal bleeding while avoiding patents held by its competitors. 

MDMA was researched and ignored off and on for several years. It wasn’t until the 1960s when psychopharmacologist Alexander Shulgin synthesized it and later studied it, introducing it to the academic world. He thought the drug might be useful in therapy as a disinhibiting medication. However, the drug has no accepted medical uses in the United States to this day.

It has been used as a recreational substance since the 1960s, and it became a popular club drug in the 1990s. MDMA is an empathogen, which means that it enhances sociability and creates feelings of love and empathy in users. For this reason, it’s a popular party drug and is used to elevate social experiences. 

MDMA isn’t known to cause severe substance use disorders in the same way other street drugs can. Even amphetamines can be more commonly addictive. However, tolerance, dependence, and addiction are possible, especially with prolonged use or high doses. 

How MDMA Affects the Brain?

MDMA defies classification because it works in the brain to produce effects that are similar to those seen in stimulants like amphetamines and psychedelics like mescaline. MDMA primarily archives its psychoactive effects by interacting with chemical messengers in the brain called serotonin, dopamine, and norepinephrine. These three chemicals are responsible for a variety of functions in the brain and body. 

They are also closely tied to reward, mood, motivation, and positive feelings. Dopamine and serotonin are two of your brain’s “happy chemicals” or “feel-good chemicals.” When they’re released, your mood lifts, and you feel excited, impassioned, and satisfied. 

MDMA has its most intense effects on serotonin, and it works by increasing the release of the chemical in the brain. The flood of serotonin in the brain causes an increased feeling of bliss, excitement, and satisfaction. It also causes increased empathy and social reward. 

However, the drug doesn’t create more serotonin; it just releases more of your existing serotonin to bind to receptors in your brain. This depletes your serotonin reserves. After the drug wears off or when all your serotonin is released, you might experience negative symptoms until your brain is able to replenish your reserves. 

Normal everyday activities and events that trigger a serotonin release and causes excitement and reward won’t have the same effect. This is called the comedown, which can cause depression, lethargy, and generally feeling down. It can take days before your brain chemistry returns to normal, and you begin to feel better.

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MDMA and Anxiety

MDMA is used as a recreational drug that’s intended to enhance social experiences and elevate positive feelings, especially in party atmospheres. The drug is also being studied as a potential therapeutic drug used in psychotherapy, because of it’s potentially positive effects in lowering inhibitions and lifting your mood. However, if MDMA causes anxiety, it may be counterproductive to both its recreational and therapeutic uses. 

A 2015 study into the potential for MDMA’s use in the treatment of mood disorders and anxiety disorders. The study found that it could have some promise as a rapid-onset therapy medication. However, they concluded that there wasn’t enough evidence to prove the drug’s safety and efficacy. 

A 2014 study on rats found that the dose of MDMA was a key factor in whether or not the drug produced feelings of anxiety. Low doses seemed to lower anxiety, while higher doses produced anxiety-like behavior. The study concluded that the anxiety-inducing effects of the drug could be mitigated by limiting the dose of the drug. However, when it comes to illicit drugs, the right dose can be difficult to determine. Illicit drugs can have unpredictable amounts of the active chemical in it.

Since psychoactive substances can temporarily change your brain chemistry, many drugs can cause you to feel anxiety, depression, or other psychological side effects for a certain amount of time. But can MDMA cause or trigger an anxiety disorder? A 2018 case study reported an incidence of a patient who developed an anxiety disorder after taking a single dose of MDMA. The report showed that the development of an MDMA-induced mental health disorder is rare but possible. 

Seeking Addiction Treatment

Mental health problems like anxiety disorders and substance use disorders often go hand in hand. They may feed off of each other, making both problems worse. Effective addiction treatment should address multiple needs, including medical, psychological, social, legal, and financial issues. If you or someone you know is struggling with a substance use disorder and an anxiety disorder, it’s important to address both issues as soon as possible.

 If they are left untreated, the problem can get worse. Addiction is a progressive disease that can start to affect multiple areas of your life over time. Addressing it early can help prevent severe consequences like long-term health issues. Addressing only one problem can slow your progress and lead to a relapse. Both addiction and anxiety are treatable. To start your road to recovery today, learn more about addiction, anxiety, and how they can be treated. 

Sources

Breuning, L. G. (2012). Meet Your Happy Chemicals. from https://www.psychologytoday.com/files/attachments/59029/happy-chemicals.pdf

Kaplan, K., Kurtz, F., & Serafini, K. (2018, May 25). Substance-induced anxiety disorder after one dose of 3,4-methylenedioxymethamphetamine: a case report. from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5968564/

Karimi, S., Jahanshahi, M., & Golalipour, M. J. (2014). The effect of MDMA-induced anxiety on neuronal apoptosis in adult male rats' hippocampus. from https://www.ncbi.nlm.nih.gov/pubmed/25152052

National Institute on Drug Abuse. (2017, September). What are MDMA's effects on the brain? from https://www.drugabuse.gov/publications/research-reports/mdma-ecstasy-abuse/what-are-mdmas-effects-on-brain

Patel, R., & Titheradge, D. (2015, June). MDMA for the treatment of mood disorder: all talk no substance? from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4502590/

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