For most people, a “hit” of MDMA lasts for 3 to 6 hours. Once the pill is swallowed, it takes only about 15 minutes for MDMA to enter the bloodstream and reach the brain. About 45 minutes later, the person experiences MDMA's “high.” That’s when the drug is at its peak level. People who use MDMA might feel very alert, or “hyper,” at first. Some lose a sense of time and experience other changes in perception, such as an enhanced sense of touch. Others experience negative effects right away. They may become anxious and agitated. Sweating or chills may occur, and people may feel faint or dizzy.
MDMA can also cause muscle tension, nausea, blurred vision, and increased heart rate and blood pressure. Forceful clenching of the teeth can occur, and individuals at clubs have been known to chew on pacifiers to relieve some of the tension.
But it doesn't stop there. Even if a person takes only one pill, the side effects of MDMA—including feelings of sadness, anxiety, depression, and memory difficulties—can last for several days to a week (or longer in people who use MDMA regularly).