Interpersonal Functioning & Social ConnectednessMDMA

Is Ecstasy an “Empathogen”? Effects of ±3,4-Methylenedioxymethamphetamine on Prosocial Feelings and Identification of Emotional States in Others

This within-subjects, placebo-controlled study (n=21) found that MDMA (52,5-105mg/70kg) may be more accurately characterized as increasing social approach behavior rather than empathy as such.

Authors

  • Harriet de Wit
  • Gillinder Bedi

Published

Biological Psychiatry
individual Study

Abstract

Background

Users of ±3,4-methylenedioxymethamphetamine (MDMA), “ecstasy,” report that the drug produces unusual psychological effects, including increased empathy and prosocial feelings. These “empathogenic” effects are cited as reasons for recreational ecstasy use and also form the basis for the proposed use of MDMA in psychotherapy. However, they have yet to be characterized in controlled studies. Here, we investigate effects of MDMA on an important social cognitive capacity, the identification of emotional expression in others, and on socially relevant mood states.

Methods

Over four sessions, healthy ecstasy-using volunteers (n = 21) received MDMA (.75, 1.5 mg/kg), methamphetamine (METH) (20 mg), and placebo under double-blind, randomized conditions. They completed self-report ratings of relevant affective states and undertook tasks in which they identified emotions from images of faces, pictures of eyes, and vocal cues.

Results

MDMA (1.5 mg/kg) significantly increased ratings of feeling “loving” and “friendly”, and MDMA (.75 mg/kg) increased “loneliness”. Both MDMA (1.5 mg/kg) and METH increased “playfulness”; only METH increased “sociability”. MDMA (1.5 mg/kg) robustly decreased accuracy of facial fear recognition relative to placebo.

Conclusions

The drug MDMA increased “empathogenic” feelings but reduced accurate identification of threat-related facial emotional signals in others, findings consistent with increased social approach behaviour rather than empathy. This effect of MDMA on social cognition has implications for both recreational and therapeutic use. In recreational users, acute drug effects might alter social risk-taking while intoxicated. Socioemotional processing alterations such as those documented here might underlie possible psychotherapeutic benefits of this drug; further investigation of such mechanisms could inform treatment design to maximize active components of MDMA-assisted psychotherapy.

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Research Summary of 'Is Ecstasy an “Empathogen”? Effects of ±3,4-Methylenedioxymethamphetamine on Prosocial Feelings and Identification of Emotional States in Others'

Introduction

MDMA (±3,4-methylenedioxymethamphetamine, 'ecstasy') is commonly reported to produce so-called "empathogenic" effects, including increased empathy and prosocial feelings. Such subjective effects are cited both as reasons for recreational use and as a rationale for using MDMA as a psychotherapeutic adjunct. Although several controlled laboratory studies have demonstrated MDMA-induced increases in self-reported sociability-related states (for example friendliness, closeness, and talkativeness), there has been little direct evidence on whether MDMA alters overt social-cognitive behaviour in humans, such as the ability to identify emotions in others. Bedi and colleagues designed a within-subject, double-blind study to characterise MDMA's effects on two domains: socially relevant mood states and social cognition operationalised as emotion-recognition performance from faces, the eye region, and vocal cues. They tested two doses of MDMA (0.75 mg/kg and 1.5 mg/kg), included methamphetamine (20 mg) as a stimulant comparator, and hypothesised that MDMA would alter both self-reported sociability/empathy and accuracy on emotion-identification tasks. The authors noted that changes could reflect either improved sensitivity to others' emotions (consistent with enhanced empathy) or reduced sensitivity to threat-related signals (potentially increasing social approach behaviour).

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