Effects
Qat chewers often describe a feeling of euphoria, passivity and increased energy and concentration, fecundity and experience an increase in libido. Interestingly, both enhanced libido and sterility have been documented. High doses may induce hyperactivity and, sometimes, manic behaviour.
A meta-analysis has stated that qat creates a pleasuring effect to the same degree as ecstasy. Individuals become very talkative under the influence of the drug and may appear to be unrealistic and emotionally unstable. It is an effective anorectic and its use also results in constipation. Dilated pupils (mydriasis), which are prominent during qat consumption, reflect the sympathomimetic effects of the drug, which are also reflected in increased heart rate and blood pressure. A state of drowsy hallucinations may also result from qat usage. Withdrawal symptoms that may follow occasional use include mild depression and irritability. Withdrawal symptoms that may follow prolonged qat use include lethargy, mild depression, nightmares, and slight tremor. Long-term use can precipitate the following effects: negative impact on liver function, permanent tooth darkening (of a greenish tinge), susceptibility to ulcers, and diminished sex drive. Those who abuse the drug generally cannot stay without it for more than 4–5 days, feeling tired and having difficulty concentrating. Occasionally, a psychosis can result, resembling a hypomanic state in presentation.