It is clear that the drug is addictive for some and can often take on great importance in people's lives. Because MDMA's desired effects decrease with its continued use, daily use is less common for MDMA than it is for other stimulants. MDMA, which begins to take effect within 20 to 40 minutes, produces little rushes of exhilaration that can be accompanied by nausea. The user feels the peak effects 60 to 90 minutes after taking the drug and the effects typically last for 3 to 6 hours. At low to moderate dosages, users report that MDMA produces understanding and acceptance of others.
Users feel as though barriers disappear, and they feel less emotionally and sexually inhibited.
Psychological effects include confusion, depression, sleep problems, drug craving, severe anxiety and paranoia. Psychotic episodes have also been reported. Physical symptoms include muscle tension, involuntary teeth clenching, nausea, blurred vision, rapid eye movement, faintness and chills or sweating. Even users who are not extremely sensitive face a variety of risks. Increases in heart rate and blood pressure present a special risk for people with circulatory or heart disease.