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MDMA increases the activity of three brain chemicals:

  • Dopamine—produces increased energy/activity and acts in the reward system to reinforce behaviors
  • Norepinephrine—increases heart rate and blood pressure, which are particularly risky for people with heart and blood vessel problems
  • Serotonin—affects mood, appetite, sleep, and other functions. It also triggers hormones that affect sexual arousal and trust. The release of large amounts of serotonin likely causes the emotional closeness, elevated mood, and empathy felt by those who use MDMA.

Other health effects include:

  • nausea
  • muscle cramping
  • involuntary teeth clenching
  • blurred vision
  • chills
  • sweating

MDMA's effects last about 3 to 6 hours, although many users take a second dose as the effects of the first dose begin to fade. Over the course of the week following moderate use of the drug, a person may experience:

  • irritability
  • impulsiveness and aggression
  • depression
  • sleep problems
  • anxiety
  • memory and attention problems
  • decreased appetite
  • decreased interest in and pleasure from sex

It's possible that some of these effects may be due to the combined use of MDMA with other drugs, especially marijuana.