MDMA (3,4-Methylenedioxymethamphetamine)
An empathogen-entactogen studied by MAPS as the centerpiece of MDMA-assisted therapy for post-traumatic stress disorder (PTSD). In supervised sessions it reduces fear and defensiveness, helping people revisit traumatic memories with less distress.
How it works
Triggers large releases of serotonin (and to a lesser extent dopamine and norepinephrine) and increases oxytocin, prolactin and cortisol. This produces feelings of trust, openness and emotional closeness that support psychotherapy.
Key facts
- Molecular weight: 193.25 g/mol
- Half-life: ~7-9 hours
- Bioavailability: Oral, high
- Storage: Research/clinical settings only.
Dosing overview
- Typical dose: 75-125 mg (often with an optional supplemental half-dose)
- Frequency: A small number of monthly sessions
- Duration: Acute effects last 4-6 hours
- Route: Oral, in a supervised therapeutic setting
Protocol notes
- In MAPS-style therapy, a person takes a measured oral dose at the start of a long session with two trained therapists present.
- They wear eyeshades and listen to music, turning attention inward while the therapists support them through difficult memories.
- Sessions run several hours and are spaced weeks apart, with regular non-drug therapy in between.
- Recreationally it is taken as a pill or powder at events, which is far riskier: people overheat, mix it with other drugs, or take unknown doses.
Reported benefits
- Studied for treatment-resistant PTSD
- Lowers fear response during trauma processing
- Increases trust and emotional openness
- Strong Phase 3 trial results from MAPS
Possible side effects
- Jaw clenching
- Raised heart rate and blood pressure
- Overheating
- Low mood in the days after
- Risk of dangerous interactions with other serotonergic drugs
Research
- MDMA-assisted therapy for severe PTSD (Phase 3, MAPP1) (2021): 67% of participants no longer met PTSD criteria after three MDMA-assisted therapy sessions, versus 32% on placebo with therapy.
- MDMA-assisted therapy for moderate to severe PTSD (Phase 3, MAPP2) (2023): Confirmed earlier results in a broader, more diverse group, with significant reductions in PTSD symptoms.
Community reviews of MDMA
- jordan_codes rated it 4/5 - Good for opening up, but not my favorite tool: I tried MDMA over about 6 months mostly because I was stuck in a weird stress loop after work, and the openness part was real for me. I felt more able to talk through old stuff without getting locked up. Compared to a low-dose ketamine session I had tried for the same goal, I actually preferred ketamine, it felt cleaner and less messy in my head. MDMA was helpful, just a little more draining after.
- biohacker_retired rated it 5/5 - Big lift for my weekend reset: I tried MDMA for about 3 months while I was buried in grad school work and commuting around the Midwest, and to be fair it fit my life better than I expected. I’m usually in my head all week, lots of reading, lab stuff, and way too much caffeine, so the emotional openness part really stood out for me. It felt like I could talk straight, actually process stuff, and not white-knuckle everything. For me it worked best on a planned weekend, not some random night, because I wanted the next day to be clear for recovery and normal life.
- biohacker_derek rated it 4/5 - Opened Up, But Wore Me Out Socially: I tried MDMA over a couple weekends, mostly because after years behind the pharmacy counter and a divorce, I just couldnt relax or open up at all. For me, it did make it way easier to talk about stuff I normally keep bottled up. I felt lighter for a few days after. Only downside, if I used it more than once a month, I felt kinda fried and a little flat for a week or so after. 4 stars.
- nomad694 rated it 5/5 - Opened me up, but my jaw was wrecked: As an ultramarathoner in Ireland, I tried MDMA for three weeks out of curiosity about how it might ease the hard shut-down after long blocks of training and life stress, and for me it did make me feel warmer, more open, and less braced all the time, but the jaw clenching and dry mouth were classically miserable, fair play, and that bit was hard to ignore.
- vet945 rated it 4/5 - mdma made the hard conversations less sharp: i tried mdma after a rough stretch of overthinking, work stress, and too many half-hearted conversations where i felt stuck behind my own face, and for about 12 weeks it did make me more open and less braced, which was honestly quite shiok. as a personal trainer and an old paramedic, i’m used to keeping it together, so the emotional looseness surprised me more than the buzz itself. my only caveat is the comedown felt a bit flat for me, and i would not use it casually, or at all if someone has heart issues or mood problems, that needs proper medical advice, not forum bravado. in my experience,
- trains_experiment rated it 5/5 - Less fear, more honesty in my head: The biggest thing for me was how it took the edge off fear and let me talk straight about stuff I usually keep buried. After about 3 weeks, I felt calmer and way more open, like my brain quit clutching so tight. That shift was huge for me.
Compare MDMA
Research and educational reference only. Not medical advice.