Cited by 247Psychedelics and Drug StudiesNeurotransmitter Receptor Influence on BehaviorForensic Toxicology and Drug Analysis

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

Open access
Bedi, Gillinder, Hyman, David, de Wit, Harriet·2010·Biological Psychiatry

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 behavior 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.

Integrity signals

Registry

Crossref · 10.1016/j.biopsych.2010.08.003

Cites

53 of 53 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

0 of 29 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    MDMA 1.5 mg/kg increased playfulness ratings relative to placebo and MDMA 0.75 mg/kg.

    “MDMA1.5 increasing playfulness relative to PBO and MDMA0.75”
    Quote in the paperNot a substantial claim
  • Findingown data

    Accuracy on the Eyes and DANVA-2 tasks was unaffected by MDMA.

    “MDMA did not affect accuracy on the Eyes or the DANVA-2 tests (Table 1).”
    Quote in the paperSubstantial claim
  • Findingown data

    DANVA-2 scores showed no drug-by-emotion interaction.

    “There was no interaction between drug condition and emotion type on DANVA-2 scores.”
    Quote in the paperSubstantial claim
  • Findingown data

    MDMA 1.5 mg/kg significantly increased loving ratings relative to placebo.

    “MDMA1.5 significantly increased loving and friendliness ratings”
    • Also stated in: § RESULTS · hedged
      “Follow-up analyses indicated that MDMA1.5 increased loving feelings relative to PBO.”
    Quote in the paperSubstantial claim
  • Findingown data

    MDMA 0.75 mg/kg increased loneliness ratings relative to methamphetamine and placebo.

    “Post-hoc analysis showed that MDMA0.75 increased loneliness ratings relative to METH and PBO”
    Quote in the paperSubstantial claim
  • May combine two claims. 17
  • Classified as probably not a substantial claim. 13
  • May combine two claims.

    Findingown data

    The higher MDMA dose raised loving and friendliness scores above placebo, but those scores did not differ significantly from methamphetamine.

    “whereas MDMA (1.5mg/kg) significantly increased loving feelings and friendliness compared to placebo, these ratings were not significantly different from ratings on methamphetamine.”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim.

    Premisecitation

    The drug's supposed empathogenic properties are a key reason it has been proposed as an adjunct in psychotherapy.

    “MDMA’s apparent empathogenic effects are also central to the rationale for the use of the drug as a psychotherapeutic adjunct [1, 5–6].”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [1] Parrott, 2007, The psychotherapeutic potential of MDMA (3,4-methylenedioxymethamphetamine): An evidence-based review, Psychopharmacology source

      Not checked in the free run.

    • cites [5] Holland, 2001

      Not checked in the free run.

    • cites [6] Johansen, 2009, How could ecstasy help anxiety disorders?, J Psychopharmacol source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Removing two DANVA outliers did not change the findings, so the original values were kept.

    “Truncation of two outlying data points (both in DANVA scores) did not alter results and original data were retained.”
    Quote in the paperNot a substantial claim
  • Classified as probably not a substantial claim.

    Study design and conductown data

    Compliance with drug abstinence requirements was verified using urine, saliva, and breathalyzer screens.

    “Compliance was verified with urine (QuickTox Drug Screen Dipcard, Branan Medical Corporation, Irvine, CA), saliva (Oratect III, Branan Medical Corporation) and breathalyzer (Alco-sensor III, Intoximeters, St. Louis, MO) screens.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Study design and conductcitation

    MDMA doses were selected based on prior research showing they are safe and produce mood alterations.

    “Drug doses were selected based on previous research; MDMA doses in this low-to-moderate range have been safely administered to humans previously, and produce modest to robust alterations in mood state [24].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [24] Dumont, 2006, A review of acute effects of 3,4-methylenedioxymethamphetmine in healthy volunteers, J Psychopharmacol source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    MDMA is reported to cause atypical mental effects, such as heightened empathy and prosocial sentiment.

    “MDMA (±3,4-methylenedioxymethamphetamine, ‘ecstasy’) is reported to have unusual, so-called ‘empathogenic’ effects, such as increased empathy and prosocial feelings [e.g. see 1].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [1] Parrott, 2007, The psychotherapeutic potential of MDMA (3,4-methylenedioxymethamphetamine): An evidence-based review, Psychopharmacology source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductcitation

    The cognitive tests were started 65 min after dosing so that they would occur when drug effects were expected to peak.

    “Participants started cognitive tasks (e.g. emotional recognition) 65 minutes after capsule administration, to coincide with peak drug effect onset [26].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [26] Cami, 2000, Human pharmacology of 3,4-methylenedioxymethamphetamine (“ecstasy”): Psychomotor performance and subjective effects, J Clin Psychopharmacol source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductcitation

    A 20 mg methamphetamine dose was chosen for its safety and its ability to produce strong stimulant and euphoric responses in people without prior amphetamine use.

    “For the current study, we selected a methamphetamine dose (20mg) that is safe, and induces robust stimulant and euphoric effects, in amphetamine-naive volunteers [27].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [27] Wachtel, 2002, The effects of acute haloperidol or risperidone on subjective responses to methamphetamine in healthy volunteers, Drug Alcohol Depend source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Earlier controlled lab work suggests MDMA raises self-reported states tied to empathy and social ease, but findings are mixed.

    “These studies indicate that MDMA increases feelings related to empathy and sociability, including self-rated friendliness [7–8], extroversion [9–10], closeness to others [11], sociability [7, 12], talkativeness [7–8], amicability, and gregariousness [13], although some of these effects are inconsistent [14–16].”
    Quote in the paperSubstantial claim0 of 7 sources checked
    • cites [7] Tancer, 2003, Reinforcing, subjective, and physiological effects of MDMA in humans: A comparison with d-amphetamine and mCPP, Drug Alcohol Depend source

      Not checked in the free run.

    • cites [8] Tancer, 2007, The effects of fluoxetine on the subjective and physiological effects of 3,4-methylenedioxymethamphetamine (MDMA) in humans, Psychopharmacology source

      Not checked in the free run.

    • cites [9] Vollenweider, 1999, Opposite effects of 3,4-methylenedioxymethamphetamine (MDMA) on sensorimotor gating in rats versus healthy humans, Psychopharmacology source

      Not checked in the free run.

    • cites [10] Liechti, 2000, Psychological and physiological effects of MDMA (“ecstasy”) after pretreatment with the 5-HT-sub-2 antagonist ketanserin in healthy humans, Neuropsychopharmacology source

      Not checked in the free run.

    • cites [14] Liechti, 2000, Acute psychological effects of 3,4-methylenedioxymethamphetamine (MDMA, “ecstasy”) are attenuated by the serotonin uptake inhibitor citalopram, Neuropsychopharmacology source

      Not checked in the free run.

    • cites [15] Johanson, 2006, Discriminative stimulus effects of 3,4-methylenedioxymethamphetamine (MDMA) in humans trained to discriminate among d-amphetamine, meta-chlorophenylpiperazine and placebo, Drug Alcohol Depend source

      Not checked in the free run.

    • cites [16] Harris, 2002, Subjective and hormonal effects of 3,4-methylenedioxymethamphetamine (MDMA) in humans, Psychopharmacology source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    The order in which sessions occurred showed no significant effect in any analysis, so it was dropped from the models.

    “Session order did not have a significant effect in any of the analyses, and was therefore not retained in the models.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Premisecitation

    The authors' earlier imaging work found MDMA changed brain responses to social cues, yet it left behavioral accuracy for recognizing facial emotions unchanged.

    “Using fMRI, we recently reported effects of MDMA on neural processing of social material [12], but in that study the drug did not alter the behavioral response to the stimuli (i.e. accuracy of identification of emotions from pictures of facial effect).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [12] Bedi, 2009, Effects of MDMA on sociability and neural response to social threat and social reward, Psychopharmacology source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Four outcomes had non-normal distributions; non-parametric tests matched parametric results for all but VAS Lonely, and for that measure non-parametric results are reported.

    “Data for four outcome measures were non-normal (VAS Loving, VAS Lonely, POMS Friendly, and DANVA scores). In these cases, we conducted non-parametric analysis (Friedman’s ANOVA followed by Wilcoxon signed rank tests). In all cases except VAS Lonely, the non-parametric approach yielded the same results; therefore parametric statistics are reported. For VAS Lonely, non-parametric statistics yielded”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The Eyes test is sensitive to oxytocin administration.

    “The Eyes test is sensitive to oxytocin administration [33].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [33] Domes, 2007, Oxytocin improves “mind-reading” in humans, Biol Psychiatry source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The drug's empathogenic effects are given as a reason people use ecstasy recreationally and may add to its reinforcing properties.

    “Such effects are cited as a motivation to use ecstasy recreationally [2–3] and may contribute to its reinforcing capacity [4].”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [2] Thompson, 2007, A role for oxytocin and 5-HT(1A) receptors in the prosocial effects of 3,4 methylenedioxymethamphetamine (“ecstasy”), Neuroscience source

      Not checked in the free run.

    • cites [3] Sumnall, 2006, The varieties of ecstasy experience: An exploration of the subjective experiences of ecstasy, J Psychopharmacol source

      Not checked in the free run.

    • cites [4] McGregor, 2008, From ultrasocial to antisocial: A role for oxytocin in the acute reinforcing effects and long-term adverse consequences of drug use?, Br J Pharmacol source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Reading emotions from faces, voices, or posture is a core social-cognitive ability and an early component of empathy.

    “Identification of others’ emotions based on facial, vocal or postural cues is a critical social cognitive capacity and an important ‘first step’ in empathy [17]”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [17] Clark, 2008, Autism and the extraction of emotion from briefly presented facial expressions: Stumbling at the first step of empathy, Emotion source

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductown data

    The study used a 4-session, within-participants, double-blind design with randomized drug order.

    “A 4-session, within-participants, double-blind design was employed.”
    • Also stated in: § Experimental Protocol · plain
      “capsules were administered in randomized order.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Premisecitation

    The earlier imaging study could not optimally detect a behavioral drug effect because its facial expressions were obvious, shown for four seconds, and limited to a few basic emotions.

    “The emotional expressions shown were not subtle [18], they were presented for a long period (4 seconds) [17], and we selected a relatively narrow range of basic emotions (e.g. fear, anger and happiness [19]), excluding more complex, culturally-determined affective states, such as shame and jealousy [20].”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [18] Philippot, 2003, Nonverbal deficits and interpersonal regulation in alcoholics

      Not checked in the free run.

    • cites [17] Clark, 2008, Autism and the extraction of emotion from briefly presented facial expressions: Stumbling at the first step of empathy, Emotion source

      Not checked in the free run.

    • cites [19] Ekman, 2003

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Interpretationcitation

    Less intense fear perception could help patients engage with traumatic material in MDMA-assisted therapy.

    “reductions in the intensity of fear perception, including but not limited to those reported here, might facilitate engagement with traumatic material during therapy [49].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [49] Mithoefer, 2010, The safety and efficacy of ± 3,4-methylenedioxymethamphetamine-assisted psychotherapy in subjects with chronic, treatment-resistant posttraumatic stress disorder: The first randomized, controlled pilot study [published online ahead of print July 19], J Psychopharmacol

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    The 1.5 mg/kg MDMA dose changed a behavioral social-cognition measure: it lowered fear-face recognition while leaving other emotion recognition from faces and voices intact.

    “We found that MDMA (1.5mg/kg only) altered a behavioral indicator of social cognition. Specifically, it robustly reduced recognition of fearful faces, without changing recognition of other emotions from facial or vocal cues.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    Impaired social understanding could lead to greater social risk-taking during ecstasy intoxication.

    “For instance, compromised social cognition may increase social risk-taking while under the influence of the drug.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Interpretationown data

    MDMA's social-cognitive effect appeared confined to whole-face emotion recognition, with no clear effect on eye-region or vocal cues.

    “The effect of MDMA on social cognition was limited to identification of emotions from facial expressions, with no apparent effect on recognition of affective cues from the eye region or from voices.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The FER, Eyes, and DANVA-2 tasks are comparable in their sensitivity to MDMA's effects on emotion recognition.
  • May combine two claims.

    Study design and conductown data

    Weight-based dosing for MDMA but not methamphetamine probably did not matter much, since body weights were similar and only playfulness correlated with weight.

    “A third possible limitation was that we adjusted the dose to the body weight for MDMA but not for methamphetamine. This is unlikely to be a major factor because participants were within a narrow weight range (BMI 18.5 – 30), and post-hoc analysis indicated that only one measure of methamphetamine’s effects (playfulness) correlated with body weight (r = − 0.45, p = 0.04).”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Study design and conductnone given

    No task known to the authors combines social and non-social cues, so the social specificity of the results is hard to establish.

    “Second, we are not aware of tasks that include both social and non-social stimuli, making it difficult to determine the specificity of these findings to social stimuli.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Interpretationown data

    The 1.5 mg/kg dose made participants more often call non-neutral faces neutral, which seems to lower sensitivity to subtle emotional cues.

    “we found that MDMA (1.5mg/kg) increased the number of non-neutral faces erroneously identified as neutral, apparently reducing the capacity to detect subtle emotional signals.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Still facial photographs may have less real-world validity than moving images.

    “For example, the static photos of facial affect we employed may be less ecologically valid than dynamic stimuli [e.g. see 41].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [41] Zaki, 2008, It takes two: The interpersonal nature of empathic accuracy, Psychol Sci source

      Not checked in the free run.

25 of 25
  • The paper relies on this without support.

    Participants' guesses about which drug they received are a valid index of their expectancies.

    “There was no significant relationship between drug identification and any of the measures that were sensitive to drug effects.”
    “suggesting that expectancies play a minor role in these results.”
  • The paper relies on this without support.

    The FER, Eyes, and DANVA-2 tasks are comparable in their sensitivity to MDMA's effects on emotion recognition.

    “The effect of MDMA on social cognition was limited to identification of emotions from facial expressions, with no apparent effect on recognition of affective cues from the eye region or from voices.”
    “whereas the facial task required participants to identify emotions based on subtle, briefly presented pictures, there were no time limits on responding to items in the Eyes task.”
  • The paper relies on this without support.

    The study had sufficient statistical power to detect the reported effects and to support the null findings.

    “Over four sessions, healthy ecstasy-using volunteers (N=21) received MDMA (0.75mg/kg; 1.5mg/kg), methamphetamine (20mg; METH), and placebo (PBO) under double-blind, randomized conditions.”
    “MDMA did not affect accuracy on the Eyes or the DANVA-2 tests (Table 1).”
3 of 3

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • MDMA at 1.5 mg/kg, but not 0.75 mg/kg, decreased the accuracy of fear recognition and of anger and fear recognition.

    “This is in line with further results showing that 1.5 mg/kg but not 0.75 mg/kg MDMA decreased the accuracy of fear recognition (55) and anger and fear recognition (36).”
  • Two studies did not find an effect of MDMA at 0.75 mg/kg, 1.5 mg/kg, and 75 mg on the RMET.

    “In line with results obtained with the MET, two studies did not find an effect of MDMA (0.75 mg/kg, 1.5 mg/kg, and 75 mg) on the RMET (52, 55).”
  • The increased empathy for positive emotions and decreased recognition of negative emotions shown in these studies is in line with the interpretation by Bedi et al. that a decreased ability to identify negative emotions might facilitate social approach behavior and thus social interaction.

    “The increased empathy for positive emotions and decreased recognition of negative emotions shown in these studies is in line with the interpretation by Bedi et al. (55) that a decreased ability to identify negative emotions might facilitate social approach behavior and thus social interaction.”

Statistics recomputed

Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.

  • Not confirmedF(5.2, 104.6) = 3.23reported p = .008 · recomputed p = .009

    “F(5.2, 104.6) = 3.23, p = .008”

  • ConsistentF(3, 57) = 5.04reported p = .004 · recomputed p = .004

    “F(3,57) = 5.04, p = .004”

  • ConsistentF(2.7, 51) = 6.81reported p = .001 · recomputed p < .001

    “F(2.7,51) = 6.81, p = .001”

  • Consistentχ²(3) = 11.94reported p = .008 · recomputed p = .008

    “χ2(3) = 11.94, p = .008”

  • ConsistentF(3, 57) = 8.57reported p < .001 · recomputed p < .001

    “F(3,57) = 8.57, p < .001”

  • ConsistentF(2.5, 47.7) = 3.06reported p < .05 · recomputed p = .045

    “F(2.5, 47.7) = 3.06, p < .05”

  • ConsistentF(2.8, 56) = 4.45reported p = .008 · recomputed p = .008

    “F(2.8, 56.0) = 4.45, p = .008”

7 of 7

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • MDMA comparison dose is given in two different units

    Minor

    The same comparison with 20 mg amphetamine describes the MDMA dose first as 2 mg/kg and then as 2 mg. Those are different doses.

1 of 1

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Authors
Bedi, G., Hyman, D., & de Wit, H.
Affiliations
University of Chicago (US)
Corresponding author
Bedi, Gillinder
Venue
Biological Psychiatry
Publisher
Elsevier BV
Published
2010-12
Volume
68
Issue
12
Pages
1134-1140
ISSN
0006-3223 (ISSN-L)
OpenAlex
W1994271186
Cited by
247
References
53
Citations by year
2026: 12 · 2025: 20 · 2024: 23 · 2023: 38 · 2022: 8 · 2021: 12 · 2020: 13 · 2019: 10 · 2018: 16 · 2017: 14 · 2016: 13 · 2015: 15 · 2014: 21 · 2013: 13 · 2012: 9
FWCI
10.86
Type
journal article
Language
en
Open access
Locations
  • Biological Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute on Drug Abuse (DA02812)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Psychedelics and Drug Studies
  • Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Forensic Toxicology and Drug Analysis
Keywords
MDMA, ecstasy, emotion recognition, methamphetamine, social cognition, MDMA-assisted psychotherapy, social approach behavior, loneliness, playfulness, sociability, recreational drug use
MeSH terms
Adolescent, Adult, Affect, Empathy, Facial Expression, Female, Humans, Male, Methamphetamine, Photic Stimulation, Psychomotor Performance, N-Methyl-3,4-methylenedioxyamphetamine, Self Report

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Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-09-28.

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