A woman who attacked two people with an axe at a Sydney convenience store had to be sedated after grabbing a paramedic in the aftermath of the incident, a court has heard.

Evie Amati, 26, is standing trial in the NSW District Court accused of causing serious injuries to two people inside a 7-Eleven store at Enmore in January 2017.

Ms Amati has pleaded not guilty saying she was mentally ill at the time and taking gender transition hormone medication.

A paramedic who treated Ms Amati gave evidence saying she was not unconscious in the aftermath of the alleged attack.

Evie Amati's defence has said she never intended to kill anyone and was not of sound mind that night. ( Supplied: Facebook )

Ambulance officer Megan Coolahan said Ms Amati appeared unconscious when she first saw her at the scene as she was not responding to her voice and was unresponsive when she inserted a cannula.

However, when she performed an eyelid flicker test, Miss Coolahan said she responded to the stimuli.

"She wasn't unconscious. She was opening and closing her hands and making purposeful movement," she said.

"It told me she wasn't unconscious."

'I don't have a name'

The paramedic then travelled by ambulance with Ms Amati to St Vincent's Hospital for further treatment, waiting in triage for "quite some time".

"At that point she sat up. We had placed an airway in her nose. She pulled that out and became quite agitated. She had to be sedated.

"She said something along the lines of 'should I shove this up my arse' or something inappropriate.

"I asked her what her name was and she said 'I don't have a name.'

Half an hour before the attack Evie Amati allegedly updated her Facebook status to say, "Humans are only able to destroy and hate so that is what I shall do". ( Supplied: Facebook )

"She got quite agitated — at one point she grabbed me by my wrist in a lock and then nursing staff sedated her."

When cross-examined by defence barrister Charles Waterstreet about her ability to determine Ms Amati's state of mind, Ms Coolahan said Ms Amati's "recall of what had happened" suggested to her that she was aware of what was going on.

The court also heard evidence from John Farrar, a forensic pharmacologist who said that Ms Amati had a combination of alcohol, cannabis and MDA in her bloodstream.

The trial has heard previously that Ms Amati took the drug MDMA or ecstasy before the alleged offence.

Mr Farrar told the court that the difference between MDMA and MDA is that while the effects are similar, MDA "is more likely to have a hallucinogenic effect than MDMA".

Ms Amati hit Ben Rimmer in the face during the 2:00am attack and struck Sharon Hacker in the back of the head.

Mr Rimmer was buying a meat pie, and Ms Hacker was buying milk.

Ms Amati allegedly then attempted to attack a third person on the street outside.

On Wednesday the court heard that the 26-year-old met up with a Tinder date on the same night, and an hour before the attack messaged her saying: "One day I'm going to kill a lot of people and it will be your fault."

The trial continues.