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Many of the risks users face with MDMA use are similar to those found with the use of amphetamines and cocaine. They are:
Psychological difficulties, including confusion, depression, sleep problems, drug craving, severe anxiety, and paranoia - during and sometimes weeks after taking MDMA (even psychotic episodes have been reported).
Physical symptoms such as muscle tension, involuntary teeth clenching, nausea, blurred vision, rapid eye movement, faintness, and chills or sweating.
Increases in heart rate and blood pressure, a special risk for people with circulatory or heart disease.
Recent research findings also link MDMA use to long-term damage to those parts of the brain critical to thought and memory.
Also, there is evidence that people who develop a rash that looks like acne after using MDMA may be risking severe side effects, including liver damage, if they continue to use the drug.