Ecstasy (MDMA) and Panic Attacks

Ecstasy (MDMA) and Panic Attacks

Ecstasy (MDMA) and Panic Attacks

Ecstasy (MDMA) and Panic AttacksA panic attack is a form of intense anxiety that appears unexpectedly and produces a variety of mental and physical symptoms. Typically, these symptoms arise suddenly and produce their maximum effects after a period of roughly 10 minutes. People who take the illegal drug Ecstasy (MDMA) can develop long-term changes in their brain chemistry that favor the onset of a panic attack. In some cases, users of the drug who develop this problem have preexisting issues with mental illness; however, in other cases, they have no previous history of psychiatric problems.

Panic Attack Basics

In the United States, the nature of a panic attack is officially defined by guidelines set down in the Diagnostic and Statistical Manual of Mental Disorders, or DSM, a reference text used by the vast majority of mental health professionals. According to these guidelines, people experiencing such an attack have four or more simultaneous symptoms that can include dizziness or lightheadedness, a choking sensation in the throat, a pounding or rapid heartbeat, uncontrollable shaking or trembling, abdominal discomfort, nausea, chest pain, hot flashes, chills, unusual tingling or numbness in the extremities, an irrational fear of death, an irrational fear of losing one’s sanity, abnormal feelings of detachment from one’s immediate environment, or abnormal feelings of self-detachment in relation to the immediate environment. As stated previously, these symptoms typically appear without warning, develop suddenly, and reach their peak of severity within a few minutes.

In some cases, a person in the midst of a panic attack becomes so overwhelmed by its symptoms that he or she loses the ability to communicate with others or otherwise indicate his or her mental/physical state. While some people only experience a single attack, or two or three attacks spread out over a considerable amount of time, others develop repeated attacks that occur more frequently. Mental health professionals refer to this recurring pattern of panic attacks as a distinct condition called panic disorder. Common contributing factors to a panic attack include exposure to significant physical or emotional trauma, a family history of panic-related problems, and major positive or negative changes in one’s social, personal, or work life.

Ecstasy’s Effects

People who use MDMA trigger a short-term elevation in their brain levels of a substance called serotonin, which helps form part of the chemical network that gives the brain’s nerve cells the ability to communicate in a coordinated manner. In particular, serotonin acts as the brain’s mood regulator and contributes to an everyday sense of mental fitness and well-being. The artificial serotonin elevation associated with MDMA use comes with its own set of potential problems, including dangerous increases in baseline body temperature and related risks for medically serious dehydration. However, in terms of the onset of a panic attack, it is Ecstasy’s long-term effects on serotonin levels that play the most prominent role.

While consumption of a single Ecstasy dose artificially boosts the brain’s serotonin levels, habitual use of the drug can ultimately have the opposite effect by damaging the serotonin-producing cells in the brain and triggering a long-term deficit of the chemical. A person with a serotonin-depleted brain has an increased chance of experiencing mood-related problems that include both depression and anxiety. Apparently, the appearance of panic attacks in MDMA users is either directly or indirectly related to these serotonin-related mood problems, according to an extensive study review published in 2006 in the British Journal of Anaesthesia.


The risks for a panic attack are apparently directly related to the number of times any given individual uses Ecstasy, the authors of the study in the British Journal of Anaesthesia report. Still, as with panic attacks in other population groups, no one can predict the timing or circumstances of any particular episode. As noted previously, some of the Ecstasy users who experience panic attacks have a personal history of psychiatric problems; in fact, some individuals may try to self-treat their preexisting psychiatric problems through the use of Ecstasy or other drugs. Still, MDMA users without psychiatric problems also develop panic attacks, and current evidence indicates that permanent, drug-related changes in brain function may be at least partly responsible for these attacks. In some cases, Ecstasy users develop panic attacks often enough to qualify for a panic disorder diagnosis. Long-term users who stop taking the drug tend to experience a decrease in their rate of panic attacks over time.

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