Sleep deprivation impairs psychomotor function, and the stimulant effects of MDMA are not sufficient to compensate for this impairment. In a randomized, double-blind, placebo-controlled crossover study, 16 recreational MDMA users received single doses of 25, 50, and 100 mg. While MDMA did not generally affect performance, the highest dose improved rapid information processing in the morning after administration. In the evening, MDMA increased subjective ratings of positive mood at every dose and subjective arousal at the highest dose, but these subjective effects were no longer present after a night of sleep loss.
Taking MDMA (ecstasy) during the night does not improve driving performance the next morning after sleep loss, nor does it counteract the impairing effects of sleep deprivation. In a controlled driving test, weaving (measured as standard deviation of lateral position) was significantly increased during morning drives after a night without sleep, regardless of whether participants had taken 0, 25, 50, or 100 mg of MDMA the previous evening. The degree of impairment was clinically relevant and comparable to that seen with a blood alcohol concentration above 0.8 mg/mL. MDMA cannot compensate for sleep-loss-induced driving impairment, and sleep-deprived drivers who have taken MDMA are unfit to drive.