Regular MDMA users report both positive and negative psychological effects. Among 466 regular users, acute effects include positive and negative impacts on mental health and physical effects. Between sessions, 83% experienced low mood and 80% impaired concentration. Long-term effects include tolerance (59%), impaired concentration (38%), depression (37%), and feeling more open toward people (31%). Factors such as age, gender, extent of MDMA use, and use of cocaine or amphetamine influence these effects. Users' main concern about stopping MDMA is its long-term effects on mental health.
Recreational users of MDMA ('ecstasy') show sex-dependent mood changes days after taking the drug. Women who used MDMA reported higher depression scores four days later compared to male users and non-using controls, and their mid-week depression correlated with the amount of MDMA taken. Both men and women reported lower aggression on the night of use but significantly higher aggression mid-week; in men, the increase in aggression correlated with the weekend dose. No association was found between mood and long-term use patterns. The findings suggest that central serotonin function may be temporarily reduced after acute MDMA use, with women more susceptible to mid-week low mood and both sexes showing increased aggression.