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When taken by mouth, effects begin after 30–45 minutes and last 3–6 hours.[
Adverse effects include addiction, memory problems, paranoia, difficulty sleeping, teeth grinding, blurred vision, sweating, and a rapid heartbeat. Deaths have been reported due to increased body temperature and dehydration. Following use people often feel depressed and tired. MDMA acts primarily by increasing the activity of the neurotransmitters serotonin, dopamine, and noradrenaline in parts of the brain.