Effects can also depend on the quality and purity of the drug. The effects can start after about an hour and can last up to six hours, but may last as long as 32 hours. As ecstasy may cause the body's temperature to increase it is important to keep sipping water to prevent dehydration. Drinking water does not reduce the effects of ecstasy, it only prevents dehydration. Drinking too much water, however, may lead to serious health complications in some people.
Symptoms can include loss of appetite, insomnia, depression and muscle aches.
It can also make concentration difficult - particularly on the day after ecstasy is taken. Higher doses of ecstasy can produce hallucinations, irrational behaviour, vomiting and convulsions. There is some evidence to suggest that long term use of ecstasy may cause damage to the brain, heart and liver. Overdose of ecstasy can occur and some deaths have been related to overheating and dehydration. People can develop tolerance to the pleasurable effects of ecstasy.