MDMA enhances emotional empathy and prosocial behavior
Open accessAbstract
3,4-Methylenedioxymethamphetamine (MDMA, 'ecstasy') releases serotonin and norepinephrine. MDMA is reported to produce empathogenic and prosocial feelings. It is unknown whether MDMA in fact alters empathic concern and prosocial behavior. We investigated the acute effects of MDMA using the Multifaceted Empathy Test (MET), dynamic Face Emotion Recognition Task (FERT) and Social Value Orientation (SVO) test. We also assessed effects of MDMA on plasma levels of hormones involved in social behavior using a placebo-controlled, double-blind, random-order, cross-over design in 32 healthy volunteers (16 women). MDMA enhanced explicit and implicit emotional empathy in the MET and increased prosocial behavior in the SVO test in men. MDMA did not alter cognitive empathy in the MET but impaired the identification of negative emotions, including fearful, angry and sad faces, in the FERT, particularly in women. MDMA increased plasma levels of cortisol and prolactin, which are markers of serotonergic and noradrenergic activity, and of oxytocin, which has been associated with prosocial behavior. In summary, MDMA sex-specifically altered the recognition of emotions, emotional empathy and prosociality. These effects likely enhance sociability when MDMA is used recreationally and may be useful when MDMA is administered in conjunction with psychotherapy in patients with social dysfunction or post-traumatic stress disorder.
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MDMA primarily stimulates the release of serotonin, norepinephrine, and dopamine, while also promoting oxytocin release.
“MDMA primarily stimulates the release of serotonin (5-HT), norepinephrine (NE), and dopamine (DA), while also promoting oxytocin release.”
From Psychoanalytically informed MDMA-assisted therapy for pathological narcissism: a novel theoretical approach (2025) · cites this paper as [81]
The Discussion describes serotonin and norepinephrine release as MDMA’s primary mechanism of action, and the Abstract reports increased plasma oxytocin after MDMA. The cited paper does not identify dopamine as one of the neurotransmitters MDMA primarily releases; a search for dopamine found no supporting passage. (LLM, conf=0.88)
Experimental — accuracy not yet measuredMDMA enhances self-compassion and empathy and facilitates deeper self-reflection and interpersonal engagement.
“Kuypers (157) and Hysek et al. (81) found that MDMA enhances self-compassion and empathy and facilitates deeper self-reflection and interpersonal engagement, which may promote self-efficacy in these patients.”
From Psychoanalytically informed MDMA-assisted therapy for pathological narcissism: a novel theoretical approach (2025) · cites this paper as [81]
The Abstract reports increased emotional empathy in healthy volunteers and increased prosocial behavior in men; the Discussion suggests these effects may enhance sociability. The paper does not report enhanced self-compassion or deeper self-reflection, and it does not establish deeper interpersonal engagement. (LLM, conf=0.90)
Experimental — accuracy not yet measuredMDMA's prosocial effects (increased sociability, decreased social sensitivity) are linked to improved therapeutic engagement, making patients less guarded and more willing to explore painful emotional material.
“Additionally, its prosocial effects - such as increased sociability and decreased social sensitivity - have been linked to improved therapeutic engagement (81, 88), making patients less guarded and more willing to explore painful emotional material.”
From Psychoanalytically informed MDMA-assisted therapy for pathological narcissism: a novel theoretical approach (2025) · cites this paper as [81]
The Discussion (page not provided) says MDMA likely enhances sociability, reduces recognition of negative emotions in others, and may facilitate processing emotionally distressing material during psychotherapy. The study tested healthy volunteers, not therapeutic engagement in patients; it does not establish that patients become less guarded or more willing to explore painful material. (LLM, conf=0.87)
Experimental — accuracy not yet measuredThe tendency for MDMA to strengthen emotional responses to positive social stimuli is likely to make therapists' responses of compassion and warmth more salient at a visceral level.
“Furthermore, the tendency for MDMA to strengthen emotional responses to positive social stimuli (44, 122) is likely to make therapists' responses of compassion and warmth more salient at a visceral level.”
From MDMA-Assisted Therapy as a Means to Alter Affective, Cognitive, Behavioral, and Neurological Systems Underlying Social Dysfunction in Social Anxiety Disorder (2021) · cites this paper as [122]
Hallucinogens and entactogens have been shown to successfully modulate social processing in rigorous scientific studies.
“Entactogens as well as hallucinogens have been shown to successfully modulate social processing in rigorous scientific studies (10–12).”
From Modulation of Social Cognition via Hallucinogens and “Entactogens” (2019) · cites this paper as [10]
MDMA at 125 mg increased the subjective experience of being close to others and trusting others by approximately 25% during peak effects.
“Furthermore, MDMA (125 mg) increased the subjective experience of being close to others and trusting others by approximately 25% during peak effects (10, 39).”
From Modulation of Social Cognition via Hallucinogens and “Entactogens” (2019) · cites this paper as [10]
MDMA at 75, 100, and 125 mg, GHB at 20 mg/kg, and psilocybin at 0.215 mg/kg did not affect cognitive empathy on the MET.
“In line with this, MDMA (75, 100, & 125 mg), GHB (20 mg/kg), and psilocybin (0.215 mg/kg) did not affect cognitive empathy on the MET (10, 12, 51–53, 62).”
From Modulation of Social Cognition via Hallucinogens and “Entactogens” (2019) · cites this paper as [10]
A 125 mg dose of MDMA impaired the identification of fearful faces and, in a second study, of fearful, angry, and sad faces, particularly in women.
“Additionally, a 125 mg dose of MDMA impaired the identification of fearful faces (39) and of fearful, angry, and sad faces, particularly in women, in a second study (10).”
From Modulation of Social Cognition via Hallucinogens and “Entactogens” (2019) · cites this paper as [10]
In two studies, the MDMA-induced increase in emotional empathy was particularly pronounced in response to positive stimuli and in male participants.
“In two studies this increase was particularly pronounced in response to positive stimuli and in male participants (10, 51).”
From Modulation of Social Cognition via Hallucinogens and “Entactogens” (2019) · cites this paper as [10]
Both 125 mg and 75 mg MDMA increased emotional empathy.
“One hundred twenty-five milligrams as well as 75 mg MDMA increased emotional empathy (10, 51, 52).”
From Modulation of Social Cognition via Hallucinogens and “Entactogens” (2019) · cites this paper as [10]
No effect was found for female participants on the Social Value Orientation Test after 125 mg MDMA, potentially because they already showed high altruistic behavior following placebo administration.
“No effect was found for female participants, potentially because they already showed high altruistic behavior following placebo administration (10).”
From Modulation of Social Cognition via Hallucinogens and “Entactogens” (2019) · cites this paper as [10]
Male participants made more altruistic choices after administration of 125 mg MDMA.
“male participants made more altruistic choices after the administration of 125 mg MDMA (10).”
From Modulation of Social Cognition via Hallucinogens and “Entactogens” (2019) · cites this paper as [10]
MDMA releases 5-HT, NE, and, to a lower extent, DA from nerve terminals via action on monoamine transporters, and increases plasma levels of oxytocin, prolactin, and cortisol.
“It releases 5-HT, NE, and, to a lower extent, DA from nerve terminals via action on monoamine transporters, and increases plasma levels of oxytocin, prolactin, and cortisol (10).”
From Modulation of Social Cognition via Hallucinogens and “Entactogens” (2019) · cites this paper as [10]
Increases in emotional empathy, impaired identification of negative emotions, enhanced decoding of positive facial expressions, and increased altruistic choices after MDMA administration were not related to oxytocin plasma levels or other neuroendocrine effects.
“For example, increases in emotional empathy, impaired identification of negative emotions, enhanced decoding of positive facial expressions, and increased altruistic choices after MDMA administration were not related to oxytocin plasma levels or other neuroendocrine effects (10, 51, 52, 54).”
From Modulation of Social Cognition via Hallucinogens and “Entactogens” (2019) · cites this paper as [10]
These social functions were not influenced by acute administration of MDMA in controlled studies.
“Interestingly, these social functions were not influenced by acute administration of MDMA in controlled studies (10, 51, 52).”
From Modulation of Social Cognition via Hallucinogens and “Entactogens” (2019) · cites this paper as [10]
LSD and MDMA have shown some dose-dependent effects on empathy and altruistic behavior, indicating that robust modulations are measurable at doses of 100 mg MDMA/100μg LSD and above.
“LSD and MDMA have shown some dose-dependent effects on empathy and altruistic behavior (10, 33, 51), indicating that robust modulations are measurable at doses of 100 mg MDMA/100µg LSD and above.”
From Modulation of Social Cognition via Hallucinogens and “Entactogens” (2019) · cites this paper as [10]
MDMA enhances emotional empathy predominantly in male participants.
“It has been shown that MDMA enhances emotional empathy predominantly in male participants (10).”
From Modulation of Social Cognition via Hallucinogens and “Entactogens” (2019) · cites this paper as [10]
The acute prosocial and interpersonal effects of MDMA may support the quality of the therapeutic alliance, a potentially important factor relating to PTSD treatment adherence and outcome.
“Additionally, the acute prosocial and interpersonal effects of MDMA25,29 may support the quality of the therapeutic alliance, a potentially important factor relating to PTSD treatment adherence30 and outcome31.”
From MDMA-assisted therapy for severe PTSD: a randomized, double-blind, placebo-controlled phase 3 study (2021) · cites this paper as [29]
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Self-citation
- Authors
- Hysek, C. M., Schmid, Y., Simmler, L. D., Domes, G., Heinrichs, M., Eisenegger, C., Preller, K. H., Quednow, B. B., & Liechti, M. E.
- Affiliations
- University of Vienna (AT)
- ORCID
- Venue
- Social Cognitive and Affective Neuroscience
- Publisher
- Oxford University Press (OUP)
- Published
- 2013-10-04
- Volume
- 9
- Issue
- 11
- Pages
- 1645-1652
- ISSN
- 1749-5016 (ISSN-L)
- 1749-5024
- PMC
- PMC4221206
- OpenAlex
- W2165032621
- Cited by
- 356
- References
- 58
- Citations by year
- 2026: 24 · 2025: 38 · 2024: 37 · 2023: 58 · 2022: 27 · 2021: 31 · 2020: 17 · 2019: 18 · 2018: 23 · 2017: 26 · 2016: 25 · 2015: 18 · 2014: 14
- FWCI
- 21.14
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc
- Locations
- Social Cognitive and Affective Neuroscience (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- edoc (University of Basel) (acceptedVersion, other-oa)
- Research Bank (Australian Catholic University) (submittedVersion)
- FreiDok plus (Universitätsbibliothek Freiburg) (submittedVersion)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion)
- Funders
- National Science Foundation
- Universität Basel
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (138481, 144996, 320030)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychedelics and Drug Studies
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Social Sciences › Psychology › Social Psychology › Neuroendocrine regulation and behavior
- Keywords
- MDMA, ecstasy, empathic concern, affective empathy, prosocial behavior, sex differences, facial emotion recognition, social value orientation, cortisol, prolactin, oxytocin, serotonin, norepinephrine, acute drug effects, sociability
- MeSH terms
- Adult, Analysis of Variance, Double-Blind Method, Emotions, Empathy, Face, Female, Glycopeptides, Hallucinogens, Humans, Interpersonal Relations, Male, Oxytocin, Pattern Recognition, Visual, Social Behavior, Cross-Over Studies, N-Methyl-3,4-methylenedioxyamphetamine, Young Adult, Visual Analog Scale
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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