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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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In the citing paper
“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]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“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]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“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]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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 the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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
Metadata
- 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
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › 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
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