Ecstasy raises body temperature. Users frequently take MDMA at a club or rave setting where they dance for long periods. MDMA increases the desire to exercise beyond the user's limitations. The ambient temperatures and excessive exercise both increase body temperature. Sometimes, the ecstasy tablets are not 100% pure and contains dangerous substances (such as DXM) that also raise body temperature. Hyperthermia is probably the result of an interaction of drug effects, setting of use, and user's behavior.
MDMA induces vasoconstriction (blood vessel narrowing) which slows heat loss. When overheating occurs, the body loses fluids. MDMA may mask the feeling of thirst. Dehydration impairs sweating and therefore cooling. It is essential to take in fluids in order to prevent dehydration.
These are warning signs of dehydration and possible heat stroke (hyperthermia) taken from the "dancesafe.org" website:
It is suggested by "dancesafe.org" that users are adequatly hydrated before MDMA use and continued fluid intake should be aimed towards replacing water lost through sweat (or vomiting). Be careful not to drink too much water since water may increase the risk of hyponatremia (low plasma sodium concentration that can lead to death). It is also advised that users consume sports drinks and eat salty food.
If exercise lasts more than 1 hour, in order for fluid replacement it is recommended to drink about 600-1200 mL/hr (20-40 oz/hr) of cool fluids. The fluids should contain about 4%-8% carbohydrates and 0.5-0.7 grams sodium/L water (Convertino et al. 1996).
This fluid replacement recommendation is based on athletes who work up a sweat due to exercise and so the volumes recommended may likely be too much for MDMA users who are not exercising or losing fluids through sweat or vomit.
Impaired attention and concentration