Side effects include jaw spasms, muscle tremors, nausea/vomiting, increased blood pressure palpitations, cardiac arrhythmias, headache, and diarrhea. On the psychological level, agitation and inner restlessness, physical agitation, anxiety, and panic may occur. The heart, liver, and kidneys become particularly stressed. Body temperature is greatly increased; there is a risk of heat stroke and even cerebral edema or multiple organ failure. In overdose, muscle spasms and hallucinations may occur. MDMA can in rare cases cause epileptic seizures, psychosis, kidney and liver failure, brain hemorrhages and heart attacks!
Frequent and intensive use of MDMA can alter the serotonin system. Repeated high doses increase the risk of impaired memory functions. The extent to which these recover with prolonged abstinence is as yet unclear. An increased risk of affective disorders and anxiety disorders is suspected as a result of chronic MDMA use. Occasionally, even after one-time MDMA use, users report that "nothing is the same afterwards," with permanent mood and perceptual changes, loss of libido, personality changes, and impaired thinking. MDMA, like LSD, although less common, can lead to flashback phenomena that can be psychologically distressing over the long term. Chronic MDMA use can lead to heart failure and persistent liver damage.
Caution. MDMA content in pills and purity of powder can vary greatly. There can be extremely strong pills in circulation, which are unsuitable for first-time users because they are life-threatening. Sometimes pills are sold as MDM pills that contain other active ingredients. In addition, pills with synthetic impurities are always in circulation.