Ecstasy-Induced Psychosis

Ecstasy is one of the street names for 3,4-Methylenedioxymethamphetamine (MDMA), which is a synthetic drug that possesses both stimulant and hallucinogenic effects.

Other street names for it include X, XTC, Adams, Beans, Love Drug, and Molly. This drug alters mood and perception.

The misuse of ecstasy can lead to negative consequences. One disturbing consequence that sometimes happens when ecstasy is used, particularly in large quantities or over a long period of time is ecstasy-induced psychosis.

Psychosis refers to losing touch with reality, which includes seeing, hearing, feeling and believing things that aren’t real. Psychosis is a symptom, not an illness. It has a lot of possible causes, one of which is the abuse of substances. Ecstasy is a substance that is known to sometimes induce psychosis.

An individual that is experiencing substance-induced psychosis may have delusions, hallucinations or both. Delusions may cause the individual to hold onto beliefs that aren’t true. Hallucinations can cause a person to see, hear or feel thing aren’t there.

Types of Ecstasy-Induced Psychosis

Drugs affect different people in different ways, and those who experience psychotic symptoms as a result of using ecstasy may experience a wide range of unpredictable symptoms, from paranoia and confusion to violence and aggression. Users may also experience mood swings and disorganized thought patterns.

People who experience ecstasy-induced psychosis may have different types of hallucinations. These may include:

• Visual. Seeing shadows, people or other things that aren’t really there
• Auditory. Hearing internal or external voices is a possible consequence of ecstasy-induced psychosis
• Tactile. Users may smell, taste or feel things that aren’t there

Ecstasy is a Schedule I substance, which means that it has high potential for abuse and that it currently has no accepted medical use. It’s often used by adolescents and young adults as a party drug. Other facts and statistics include the following:

• More than 17 million people at least 12 years of age or older reported using MDMA at least once in their lifetime in a survey done by the National Survey on Drug Use and Health in 2014
• As of 2014, the number of people who used this drug within the past month was approximately 660,000
• There were more than 22,400 visits to the emergency room relate to the use and abuse of ecstasy in 2011
• Between 2005 and 2011, approximately one-third of emergency room visits involving ecstasy in patients under the age of 21 also involved alcohol
• Use of MDMA was reported by 2.7 percent of 12th graders in the 2016 survey on teen drug use done by the National Institute on Drug Abuse

Those that use ecstasy are seeking pleasurable feelings such as loss of inhibition, euphoria, and empathy. For most people, taking ecstasy leads to short-term good feelings that wear off after a few hours. But for some people, abuse of ecstasy, typically in large doses or over a long period of time can lead to substance-induced psychotic disorder.

When this happens, the user experiences hallucinations, delusions or both that are in excess of what is experienced while intoxicated. Symptoms may start during intoxication or during withdrawal.

Other unpleasant symptoms users may experience which sometimes last for weeks after ingestion include:

• Severe paranoia
• Confusion
• Panic attacks
• Rage
• Dangerous and violent behavior
• Depression
• Suicidal thoughts
• Antisocial behavior
• Incoherent thoughts
• Disorganized speech

A medical professional will try to determine whether symptoms of psychosis were present before the ingestion of the substance in order to diagnose an individual with substance-induced psychosis

Causes and Risk Factors

People often don’t realize that when they take ecstasy, it may not be pure, but may be mixed with other potentially deadly drugs such as ketamine, amphetamine, methamphetamine, and caffeine. When other drugs are mixed with MDMA, the risk for negative consequences increases. Long periods of drug use, particularly when multiple substances are used, can lead to psychotic symptoms similar to those experienced by people with schizophrenia, bipolar disorder, and other forms of mental health challenges.

Ecstasy-induced psychosis appears to be rare, probably because binges don’t usually last a long time like they do on other substances, such as methamphetamine. Mixing ecstasy with other substances, whether intentional or not, can increase the risk of experiencing psychosis.

Substance use disorder is common in people who experience ecstasy-induced psychosis. Long-term drug abuse causes changes in the brain, and it is known that MDMA use on a long-term basis can lead to ongoing problems such as depression and problems with attention span and memory.

In many people, there is a genetic component which predisposes a person to developing mental illness. A person with untreated mental illness frequently turns to substances to self-medicate, which may also increase their chances of developing drug-induced psychosis. Those who use ecstasy may also have co-occurring disorders such as depression or anxiety. The misuse of ecstasy and other substances may make it clear that the individual has a form of mental illness such as schizophrenia that hasn’t yet been diagnosed.

When a person experiences symptoms of ecstasy-induced psychosis, these symptoms may subside on their own. The individual may benefit from simply resting in a quiet environment, or a medical professional may decide to administer antipsychotic medications to relieve symptoms, particularly if the symptoms linger for days or weeks after the drug is discontinued.

The prognosis of ecstasy-induced psychosis is usually good, but there is at least one known case of persistent symptoms of psychosis after using ecstasy only once. For most people, symptoms of ecstasy-induced psychosis will stop soon after the drug is stopped.

An individual who habitually uses substances may need inpatient treatment for substance use disorder in order to overcome their mental and physical dependence on mind-altering substances. In an inpatient environment, the individual can go through detoxification in safe environment supervised by medical professionals. Once chemicals are out of the patient’s system, doctors will have a clearer picture of whether psychotic episodes were related to the substances ingested or an underlying mental illness.

For most people, the psychotic symptoms will subside after detoxification. During residential treatment, underlying mental health challenges can be addressed. In recovery, individuals are able to go through behavioral therapy and get involved with support groups where they can learn new coping skills.

If psychotic symptoms do persist after detoxification, treatment will include finding an effective antipsychotic medication along with counseling. It is possible to obtain effective treatment for psychotic symptoms and to learn to live a life that doesn’t depend on the use of mind-altering substances.

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