What are some more long term effects of MDMA?

Long-term use of MDMA can lead to persistent changes in brain function, particularly affecting serotonin levels, which may result in mood disorders such as depression and anxiety. Users may also experience memory impairment and difficulties with cognitive functions. Additionally, prolonged use can lead to increased tolerance, prompting higher doses that elevate the risk of adverse physical and psychological effects. Lastly, there may be potential for developing substance use disorders as users seek to replicate the drug's euphoric effects.