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MDMA enhances positive affective responses to social feedback

In a double-blind, placebo-controlled crossover trial in 36 healthy adults, the high dose of MDMA (1.5 mg/kg) — but not the lower dose — increased positive affective responses to personalised social feedback compared with placebo and methamphetamine. This suggests a potential mechanism by which MDMA may enhance social connection and support its use as a psychotherapy adjunct.

Authors

  • Harriet de Wit
  • Anya Bershad

Published

Journal of Psychopharmacology
individual Study

Abstract

Background

The prosocial compound ± 3,4-methylenedioxymethamphetamine (MDMA) is an amphetamine derivative that has shown promise as an adjunct to psychotherapy in the treatment of post-traumatic stress disorder. MDMA increases positive responses to social images, and it has been suggested that the ability of MDMA to positively bias social perception may underlie its therapeutic efficacy as a psychotherapy adjunct. However, the effect of the compound on affective responses to positive or negative social feedback has not been tested.

Aims

In this study, we aimed to test the effects of MDMA compared to placebo and the prototypical stimulant, methamphetamine (MA), on responses to positive and negative social feedback.

Methods

This was a double-blind, placebo-controlled, crossover trial (NCT03790618), comparing the effects of two doses of MDMA (0.75 mg/kg, 1.5 mg/kg) to both placebo and MA (20 mg) on responses to a personalized social feedback task, similar to a dating app, in healthy adult volunteers ages 18–40 ( N = 36, 18 women, 18 men). Results/Outcomes: The high dose of MDMA increased positive affective responses to social feedback. Conclusions/Interpretations: These findings suggest one process by which MDMA may facilitate social connection. Further work is needed to understand how MDMA affects responses to more generalized types of social feedback and to understand these effects in clinical populations.

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Research Summary of 'MDMA enhances positive affective responses to social feedback'

Introduction

Bershad and colleagues frame social feedback processing as fundamental to functioning and note that many psychiatric disorders involve either exaggerated responses to negative social input or blunted responses to positive social input. Prior human and preclinical studies indicate that MDMA produces prosocial effects—enhancing feelings of closeness, sociability, and positive reactivity to social cues—and has shown promise as an adjunct to psychotherapy, possibly by improving therapeutic alliance. However, studies to date have mainly used simple, standardised social stimuli (for example, static emotional faces or simulated exclusion using Cyberball), and it remains unclear whether MDMA alters affective responses to overt, personalised social acceptance and rejection. The present study set out to test whether MDMA modifies emotional responses to explicit social feedback. Specifically, the investigators compared two doses of MDMA (0.75 mg/kg and 1.5 mg/kg) with placebo and with an active stimulant comparator, methamphetamine (MA, 20 mg), using a personalised Social Feedback Task that simulates a dating-app style acceptance/rejection interaction. The primary hypotheses were that MDMA would both enhance positive affective responses to acceptance and reduce negative affective responses to rejection.

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Study Details

References (13)

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