ecstasy

Meaning: Ecstasy is the street name for MDMA (3,4-methylenedioxymethamphetamine). It is chemically related to amphetamine and produces both stimulant effects (energy, arousal, raised heart rate and body temperature) and mild hallucinogenic effects (altered perception, emotional closeness). Its main action is on monoamine neurons. It causes serotonin to be released from the presynaptic terminal and interferes with serotonin reuptake. It also affects dopamine and norepinephrine. The result is a large rise in synaptic serotonin, felt as euphoria, empathy and sociability. Afterward, serotonin stores are depleted, so mood often dips for a time. Heavy, repeated use is linked to lasting damage to serotonin neurons.

On the MCAT: Expect questions that ask you to predict what happens at the synapse (more neurotransmitter in the cleft, reuptake blocked), or to place ecstasy among the psychoactive drug categories: depressants, stimulants, opiates and hallucinogens. Passages may also link it to the brain's reward pathway, tolerance, or the rebound mood drop after use.

Common confusion: Students file ecstasy as only a hallucinogen like LSD, or only a stimulant like cocaine. Many sources describe it as having features of both, so check which categories the answer choices offer. Also, it does not act only as a reuptake blocker. It promotes release of serotonin as well as blocking its reuptake.