As I was growing up in the late Eighties, a new drug, MDMA, materialised on the UK club scene and began percolating through society. Today, just shy of 500,000 Brits still dabble. And perhaps that’s because within 30 minutes of taking one, the shackles of inhibition fly off and everyone becomes your friend for the next five hours. But surely this type of mind-altering drug comes with a price tag.

Here’s a snapshot of MDMA and the relationship it has with you and your grey matter...

What is MDMA?

3,4-Methylendedioxymethamphetamine is the psychoactive drug that we all know as MDMA or ecstasy. It’s been a big hit on the recreational drug scene thanks to the elevated energy and heightened sensations it unlocks. Basically, the branding – ecstasy – sums it up. Still, it’s not legal and under the law you don’t really want to have this on you. It’s a class A drug and can mean a seven-year jail term – in other words, the antithesis of ecstasy.

How does MDMA work?

Deep in your brain are a trio of neurotransmitters: dopamine, noradrenaline and serotonin. These play a variety of roles in learning, cognition, sleep, attention and mood. Taking MDMA boosts the release and activity of these neurotransmitters. The result, you feel like you’ve become the living embodiment of Bradley Cooper in the 2011 movie Limitless, where anything is possible. Although all three are stimulated, it’s recognised to be the boost in serotonin that causes the euphoria associated with MDMA.

Why is it illegal?

Like a well filtered Tinder profile, MDMA is not all that it seems. Side effects loom in both the short and long term. Instant side effects include hyperthermia, insomnia, palpitations, tachycardia, teeth grinding (called bruxism), paranoia, memory impairment and failure to launch your little chap (although, of course, you may not remember this). That there will end any party. Risks of getting these depend on the individual (we all respond differently), the strength of the MDMA (now commonly around 125mg per tablet, up from 50mg in the Nineties), and frequency of use.

Can it cause brain damage or death with one dose?

The short answer is yes. The immediate risk is because MDMA can elevate core body temperature to dangerously high levels that risk triggering seizures. On top of this, MDMA can cause profound sweating which not only dehydrates you but leaches salt from your body at alarmingly high rates (hyponatremia). The natural response is to try to rehydrate with water, diluting your remaining salt content even more. Dehydration and hyponatremia can both induce seizures, independently of the hyperthermia. It’s the seizures that cause parts of the brain to have anoxic (no oxygen) brain injury. That’s your brain damaged.

OK, what about risk with longer term use?

The risk with MDMA will naturally rise with exposure. That’s the same for most drugs. Studies have demonstrated that long-term use (more than 50 doses taken in a lifetime) may alter brain structure and activity, with lesions developing in the brain pathways related to your happy hormone, serotonin. That said, like a lot of science around illegal drugs, it’s a tricky field to study.

Of course, brain damage is a chameleon of impairments from the subtle to the profound. The brain has the potential to alter irreparably with a lifetime of MDMA use. Impairments may be seen in attention, learning, memory, sleep and mood. It’s not uncommon after MDMA to see people become temporarily depressed due to the serotonin levels crashing.

Where can I get further support and information?

It doesn’t matter if you pop the occasional MDMA tab, are thinking about trying it for the first time, or are a lifelong user, knowledge is power. So, if it’s going to happen, do it with all the facts. Be aware of both the reported risks and, sure, benefits. There’s lots of online sources of information such as talktofrank.com that will fill you in with all the details. And although I might be biased, nothing beats face-to-face advice and support, so see your GP as well. They can signpost you to further agencies, information or groups.

Just remember, you only have one brain. Look after it.

Dr Nick Knight is a GP. Follow him on Twitter @DrNickKnight.