The principal acute toxic effect of MDMA is severe hyperthermia.

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Severe hyperthermia, also known as fever or heat stroke, is a serious acute toxic effect of MDMA (commonly known as ecstasy). It can cause dehydration, muscle breakdown, kidney failure, and even death. Other acute toxic effects of MDMA may include hypertension, tachycardia, arrhythmias, convulsions, serotonin syndrome, and hyponatremia. Chronic use of MDMA may lead to neurotoxicity, cognitive impairment, mood disorders, and addiction.

The Principal Acute Toxic Effect of MDMA Is Severe Hyperthermia