Multifaceted empathy of healthy volunteers after single doses of MDMA: A pooled sample of placebo-controlled studies
Open accessAbstract
Previous placebo-controlled experimental studies have shown that a single dose of MDMA can increase emotional empathy in the multifaceted empathy test (MET) without affecting cognitive empathy. Although sufficiently powered to detect main effects of MDMA, these studies were generally underpowered to also validly assess contributions of additional parameters, such as sex, drug use history, trait empathy and MDMA or oxytocin plasma concentrations. The present study examined the robustness of the MDMA effect on empathy and investigated the moderating role of these additional parameters. Participants ( n = 118) from six placebo-controlled within-subject studies and two laboratories were included in the present pooled analysis. Empathy (MET), MDMA and oxytocin plasma concentrations were assessed after oral administration of MDMA (single dose, 75 or 125 mg). Trait empathy was assessed using the interpersonal reactivity index. We confirmed that MDMA increased emotional empathy at both doses without affecting cognitive empathy. This MDMA-related increase in empathy was most pronounced during presentation of positive emotions as compared with negative emotions. MDMA-induced empathy enhancement was positively related to MDMA blood concentrations measured before the test, but independent of sex, drug use history and trait empathy. Oxytocin concentrations increased after MDMA administration but were not associated with behavioral effects. The MDMA effects on emotional empathy were stable across laboratories and doses. Sex did not play a moderating role in this effect, and oxytocin levels, trait empathy and drug use history were also unrelated. Acute drug exposure was of significant relevance in the MDMA-induced emotional empathy elevation.
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MDMA 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 [157]
The Discussion (page unavailable) reports that MDMA enhanced emotional empathy in healthy volunteers, and the Introduction describes increased sociability and closeness to others. The paper does not report enhanced self-compassion or deeper self-reflection. Its measure of compassion concerns feelings for others, not oneself. (LLM, conf=0.87)
Experimental — accuracy not yet measuredAfter a single dose of MDMA, healthy humans perceived negative emotional pictures as less aversive.
“For example, it has been reported that negative emotional pictures were perceived as less aversive after a single dose of MDMA in healthy humans (Kuypers, Dolder, Ramaekers, & Liechti, 2017).”
From Novel pharmacological targets in drug development for the treatment of anxiety and anxiety-related disorders (2019) · cites this paper as Kuypers, Dolder, Ramaekers, & Liechti, 2017
A pooled analysis confirmed the MDMA-induced increase in emotional empathy in particular for positive emotions, but did not find an influence of sex or trait empathy.
“A pooled analyses of these data confirmed the MDMA-induced increase in emotional empathy in particular for positive emotions, but did not find an influence of sex or trait empathy (62).”
From Modulation of Social Cognition via Hallucinogens and “Entactogens” (2019) · cites this paper as [62]
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Cites
Measuring individual differences in empathy: Evidence for a multidimensional approach.
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“The first two scales are a measure of CE; the two latter a measure of EE (Davis, 1983).”
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“The implicit EE (‘arousal’) was included in the MET because it is less likely to elicit a social desirability bias; it should minimize the ability to self-reflect on a more abstract level (Dziobek et al., 2008).”
BackgroundOxytocin enhances amygdala-dependent, socially reinforced learning and emotional empathy in humans
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“The scores were in the range of those found in other studies using healthy volunteers (Hurlemann et al., 2010; Thoma et al., 2011).”
BackgroundMethodResultInfluentialPersonality, mood, and cognitive processing of emotional information: Three conceptual frameworks.
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BackgroundMethodGender differences in the subjective effects of MDMA
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“Previous studies found stronger positive and especially negative subjective responses to MDMA in women than men at doses adjusted for body weight (Allott and Redman, 2007; Liechti et al., 2001).”
ResultSelf-citationMDMA enhances emotional empathy and prosocial behavior
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“Emotional empathy was enhanced after 125 mg of MDMA, mainly in men; that is, MDMA increased empathy ratings in men up to the higher placebo levels of women (Hysek et al., 2014a).”
BackgroundMethodResultInfluentialSelf-citationThe Emerging Study of Positive Empathy
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“Otherwise it could be explained as an increase in ‘positive empathy’, that is, the ability to share, celebrate, and enjoy others’ positive emotions; a state which correlates with increased prosocial behavior, social closeness, and well-being (Morelli et al., 2015).”
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“Commonly used tasks for assessing cognitive empathy are the Facial Emotion Recognition Test (FERT) and the Reading the Mind in the Eyes Test (RMET).”
BackgroundInfluentialLSD Acutely Impairs Fear Recognition and Enhances Emotional Empathy and Sociality
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“Similar to the serotonin releaser MDMA in the present study, the serotonin 5-HT2a receptor agonist LSD also enhanced explicit and implicit EE for positive stimuli in the MET (Dolder et al., 2016).”
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“Oxytocin is implicated in social behavior and it was suggested that MDMA’s effects on empathy could in part be attributed to this effect on oxytocin (Dumont et al., 2009).”
BackgroundEmotional empathy and associated individual differences
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“Although it is a general finding that females are more empathic than males, there is evidence that higher empathy levels are linked with higher potential to be aroused (Mehrabian et al., 1988).”
BackgroundKamilar-Britt, P., & Bedi, G. (2015) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2015.08.016 · Cited by 163 · cited 1× · see citing works
“Previous placebo-controlled experimental studies have also shown that a single dose of MDMA can increase sociability and different aspects of empathy (Kamilar-Britt and Bedi, 2015).”
BackgroundHysek, C. M., Simmler, L. D., Nicola, V. G., Vischer, N., Donzelli, M., Krähenbühl, S., Grouzmann, E., Huwyler, J., Hoener, M. C., & Liechti, M. E. (2012) · PLoS ONE · doi:10.1371/journal.pone.0036476 · Cited by 157 · cited 5× · see citing works
“Blood plasma samples were frozen at −20°C until analysis; MDMA concentrations were determined according to Hysek et al. (2012b) and Pizarro et al. (2002) for the Basel and Maastricht site, respectively.”
BackgroundMethodInfluentialSelf-citationDifferential effects of MDMA and methylphenidate on social cognition
Schmid, Y., Hysek, C. M., Simmler, L. D., Crockett, M. J., Quednow, B. B., & Liechti, M. E. (2014) · Journal of Psychopharmacology · doi:10.1177/0269881114542454 · Cited by 155 · cited 15× · see citing works
“The psychoactive substance in ecstasy, 3,4-methylenedioxymethamphetamine (MDMA), is known for its empathogenic effects such as increased happiness, openness, trust and closeness to others (Kirkpatrick et al., 2014b; Schmid et al., 2014).”
BackgroundMethodResultInfluentialSelf-citationMood-Congruent Memory and Natural Mood: New Evidence
Mayer, J. D., McCormick, L. J., & Strong, S. E. (1995) · Personality and Social Psychology Bulletin · doi:10.1177/0146167295217008 · Cited by 154 · cited 1× · see citing works
“This potentially reflects a mood-congruent response; individuals preferentially process emotional stimuli that are congruent with their current mood state (Mayer et al., 1995; Rusting, 1998) and this positive emotion bias could lead to more concern and arousal for people expressing alike emotions.”
BackgroundCognitive and affective empathy in depression linked to executive control
Thoma, P., Zalewski, I., von Reventlow, H. G., Norra, C., Juckel, G., & Daum, I. (2011) · Psychiatry Research · doi:10.1016/j.psychres.2011.07.030 · Cited by 151 · cited 1× · see citing works
“The scores were in the range of those found in other studies using healthy volunteers (Hurlemann et al., 2010; Thoma et al., 2011).”
ResultMDMA enhances “mind reading” of positive emotions and impairs “mind reading” of negative emotions
Hysek, C. M., Domes, G., & Liechti, M. E. (2012) · Psychopharmacology · doi:10.1007/s00213-012-2645-9 · Cited by 144 · cited 5× · see citing works
“Blood plasma samples were frozen at −20°C until analysis; MDMA concentrations were determined according to Hysek et al. (2012b) and Pizarro et al. (2002) for the Basel and Maastricht site, respectively.”
BackgroundMethodInfluentialSelf-citationEffects of MDMA and intranasal oxytocin on social and emotional processing
Kirkpatrick, M. G., Lee, R., Wardle, M. C., Jacob, S., & de Wit, H. (2014) · Neuropsychopharmacology · doi:10.1038/npp.2014.12 · Cited by 143 · cited 4× · see citing works
“While Kirkpatrick and colleagues (2014a) previously showed moderate tolerance to the subjective drug effects in more experienced users (Kirkpatrick et al., 2014a), the present study did not detect a relation between lifetime ecstasy history and the behavioral effects of MDMA on the MET.”
BackgroundInfluentialHysek, C. M., Simmler, L. D., Schillinger, N., Meyer, N., Schmid, Y., Donzelli, M., Grouzmann, E., & Liechti, M. E. (2013) · The International Journal of Neuropsychopharmacology · doi:10.1017/s1461145713001132 · Cited by 126 · cited 14× · see citing works
“Emotional empathy was enhanced after 125 mg of MDMA, mainly in men; that is, MDMA increased empathy ratings in men up to the higher placebo levels of women (Hysek et al., 2014a).”
BackgroundMethodResultInfluentialSelf-citationPizarro, N., Ortuno, J., Farré, M., LÓPEZ, C. H., Pujadas, M., Llebaria, A., Joglar, J., Roset, P. N., Más, M., Segura, J., et al. (2002) · Journal of Analytical Toxicology · doi:10.1093/jat/26.3.157 · Cited by 113 · cited 1× · see citing works
“Blood plasma samples were frozen at −20°C until analysis; MDMA concentrations were determined according to Hysek et al. (2012b) and Pizarro et al. (2002) for the Basel and Maastricht site, respectively.”
MethodMDMA, methamphetamine, and CYP2D6 pharmacogenetics: what is clinically relevant?
de la Torre, R., Yubero‐Lahoz, S., Lozano, R. P., & Farré, M. (2012) · Frontiers in Genetics · doi:10.3389/fgene.2012.00235 · Cited by 110 · cited 1× · see citing works
“Individual MDMA concentrations are mainly determined by the MDMA dose per body weight and the individual’s function of CYP2D6, the main enzyme involved in the metabolism of MDMA (de la Torre et al., 2012; Schmid et al., 2016).”
BackgroundKuypers, K. P. C., de la Torre, R., Farre, M., Yubero-Lahoz, S., Dziobek, I., Van den Bos, W., & Ramaekers, J. G. (2014) · PLoS ONE · doi:10.1371/journal.pone.0100719 · Cited by 88 · cited 16× · see citing works
“The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Swiss National Science Foundation (grant no. 320030_149493 and 320030_170249 awarded to MEL) and by the Netherlands Organization for Scientific Research (g…”
BackgroundResultInfluentialSelf-citationMDMA effects consistent across laboratories
Kirkpatrick, M. G., Baggott, M. J., Mendelson, J. E., Galloway, G. P., Liechti, M. E., Hysek, C. M., & de Wit, H. (2014) · Psychopharmacology · doi:10.1007/s00213-014-3528-z · Cited by 75 · cited 4× · see citing works
“While Kirkpatrick and colleagues (2014a) previously showed moderate tolerance to the subjective drug effects in more experienced users (Kirkpatrick et al., 2014a), the present study did not detect a relation between lifetime ecstasy history and the behavioral effects of MDMA on the MET.”
BackgroundInfluentialSelf-citationHysek, C. M., & Liechti, M. E. (2012) · Psychopharmacology · doi:10.1007/s00213-012-2761-6 · Cited by 58 · cited 11× · see citing works
“The six studies were all individually approved by either the Ethics Committee of Basel, Switzerland (Hysek et al., 2014a; Hysek and Liechti, 2012; Schmid et al., 2014, 2015) or the Medical Ethics Committee of the Academic Hospital of Maastricht and Maastricht University (Kuypers et al.”
BackgroundMethodResultInfluentialSelf-citationAllott, K., & Redman, J. R. (2006) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2006.09.009 · Cited by 56 · cited 1× · see citing works
“Previous studies found stronger positive and especially negative subjective responses to MDMA in women than men at doses adjusted for body weight (Allott and Redman, 2007; Liechti et al., 2001).”
ResultSchmid, Y., Vizeli, P., Hysek, C. M., Prestin, K., zu Schwabedissen, H. E. M., & Liechti, M. E. (2016) · Pharmacogenetics and Genomics · doi:10.1097/fpc.0000000000000231 · Cited by 53 · cited 2× · see citing works
“Individual MDMA concentrations are mainly determined by the MDMA dose per body weight and the individual’s function of CYP2D6, the main enzyme involved in the metabolism of MDMA (de la Torre et al., 2012; Schmid et al., 2016).”
BackgroundMethodSelf-citationDolder, P. C., Holze, F., Liakoni, E., Harder, S., Schmid, Y., & Liechti, M. E. (2016) · Psychopharmacology · doi:10.1007/s00213-016-4431-6 · Cited by 52 · cited 2× · see citing works
“Finally, a low dose of alcohol also increased explicit EE ratings for positive stimuli similar to MDMA, but alcohol did not alter levels of circulating oxytocin and also produced different subjective effects than MDMA (Dolder et al., 2017).”
BackgroundMethodSelf-citationInteractions between Bupropion and 3,4-Methylenedioxymethamphetamine in Healthy Subjects
Schmid, Y., Rickli, A., Schaffner, A., Duthaler, U., Grouzmann, E., Hysek, C. M., & Liechti, M. E. (2015) · Journal of Pharmacology and Experimental Therapeutics · doi:10.1124/jpet.114.222356 · Cited by 51 · cited 5× · see citing works
“Four studies were conducted in Basel, Switzerland (Hysek et al., 2014a; Hysek and Liechti, 2012; Schmid et al., 2014, 2015) and two in Maastricht, the Netherlands (Kuypers et al., 2014, 2016).”
BackgroundMethodResultInfluentialSelf-citation
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Psychedelics and Psychedelic-Assisted Psychotherapy
Reiff, C. M., Richman, E. E., Nemeroff, C. B., Carpenter, L. L., Widge, A. S., Rodriguez, C. I., Kalin, N. H., McDonald, W. M., & and the Work Group on Biomarkers and Novel Treatments, A. D. O. T. A. P. A. C. O. R. (2020) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2019.19010035 · Cited by 649 · see citing works
“MDMA Serotonin 5-HT2A agonist; mixed serotonin, norepinephrine, and dopamine reuptake inhibition and release Deficits in spatial memory (111); mild impairment on psychomotor tasks (92) Changes in body perception, slight visual and auditory alterations, no hallucinations (92) Distrust and hostility (103); anxiety (93,…”
BackgroundDanforth, A. L., Grob, C. S., Struble, C., Feduccia, A. A., Walker, N., Jerome, L., Yazar-Klosinski, B., & Emerson, A. (2018) · Psychopharmacology · doi:10.1007/s00213-018-5010-9 · Cited by 280 · see citing works
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Distinct acute effects of LSD, MDMA, and d-amphetamine in healthy subjects
Holze, F., Vizeli, P., Müller, F., Ley, L., Duerig, R., Varghese, N., Eckert, A., Borgwardt, S., & Liechti, M. E. (2020) · Neuropsychopharmacology · doi:10.1038/s41386-019-0569-3 · Cited by 247 · see citing works
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Modern clinical research on LSD
Liechti, M. E. (2017) · Neuropsychopharmacology · doi:10.1038/npp.2017.86 · Cited by 236 · see citing works
“LSD impaired the recognition of sad and fearful faces (Dolder et al, 2016) and enhanced emotional empathy (Dolder et al, 2016), similar to psilocybin (Kometer et al, 2012; Preller et al, 2015) and MDMA (Hysek et al, 2014a; Kuypers et al, 2017).”
BackgroundSub-Acute Effects of Psilocybin on Empathy, Creative Thinking, and Subjective Well-Being
Mason, N. L., Mischler, E., Uthaug, M. V., & Kuypers, K. P. C. (2019) · Journal of Psychoactive Drugs · doi:10.1080/02791072.2019.1580804 · Cited by 172 · see citing works
“…analysis of the MET have shown to be in the good to highly satisfactory range (Dziobek et al. 2008), and previous studies have found it to be sensitive to the effects of psychedelics (Hysek et al. 2014; Kuypers et al. 2014, 2017; Pokorny et al. 2017; Preller et al. 2015; Schmid et al. 2014).”
BackgroundSelf-citationA review of 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy
Sessa, B., Higbed, L., & Nutt, D. (2019) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00138 · Cited by 141 · see citing works
Dolder, P. C., Müller, F., Schmid, Y., Borgwardt, S. J., & Liechti, M. E. (2018) · Psychopharmacology · doi:10.1007/s00213-017-4650-5 · Cited by 117 · see citing works
“This dose of MDMA is in the high range of the doses typically used in clinical research (Kirkpatrick et al. 2015; Kirkpatrick et al. 2014a; Kuypers et al. 2017) but also used in clinical studies in patients with PTSD (Mithoefer et al. 2010; Oehen et al. 2013) and is within the dose range that is…”
InfluentialSelf-citationUthaug, M. V., Mason, N. L., Toennes, S. W., Reckweg, J. T., de Sousa Fernandes Perna, E. B., Kuypers, K. P. C., van Oorsouw, K., Riba, J., & Ramaekers, J. G. (2021) · Psychopharmacology · doi:10.1007/s00213-021-05817-8 · Cited by 112 · see citing works
“This increase in empathic emotion was assessed with theMET that might be less susceptible to the influence of nonpharmacological factors and fluctuates with drug concentration (Kuypers et al. 2017b).”
Self-citationDark Classics in Chemical Neuroscience: 3,4-Methylenedioxymethamphetamine
Dunlap, L. E., Andrews, A. M., & Olson, D. E. (2018) · ACS Chemical Neuroscience · doi:10.1021/acschemneuro.8b00155 · Cited by 106 · see citing works
Kiraga, M. K., Mason, N. L., Uthaug, M. V., van Oorsouw, K. I. M., Toennes, S. W., Ramaekers, J. G., & Kuypers, K. P. C. (2021) · Frontiers in Pharmacology · doi:10.3389/fphar.2021.721537 · Cited by 85 · see citing works
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Bird, C., Modlin, N. L., & Rucker, J. (2021) · International Review of Psychiatry · doi:10.1080/09540261.2021.1919062 · Cited by 84 · see citing works
“Increased emotional empathy (Kuypers et al., 2017), subjective ratings of closeness to others and increased feelings of trust (Schmid et al., 2014) have been seen following MDMA.”
BackgroundThe Psychedelic Future of Post-Traumatic Stress Disorder Treatment
Zaretsky, T. G., Jagodnik, K. M., Barsic, R., Antonio, J. H., Bonanno, P. A., MacLeod, C., Pierce, C., Carney, H., Morrison, M. T., Saylor, C. F., et al. (2024) · Current Neuropharmacology · doi:10.2174/1570159x22666231027111147 · Cited by 85 · see citing works
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Schmid, Y., Gasser, P., Oehen, P., & Liechti, M. E. (2021) · Journal of Psychopharmacology · doi:10.1177/0269881120959604 · Cited by 85 · see citing works
“, 2014, 2015a), reduced the perception of negative emotions, and enhanced empathy (Bedi et al., 2009; Dolder et al., 2016; Hysek et al., 2014a; Kuypers et al., 2017).”
BackgroundSelf-citationProgress and promise for the MDMA drug development program
Feduccia, A. A., Holland, J. A., & Mithoefer, M. C. (2017) · Psychopharmacology · doi:10.1007/s00213-017-4779-2 · Cited by 78 · see citing works
“However, interpretation is limited because Kuypers et al. (2014, 2017) did not measure within-subject correlation of subjective effects with multiple post-MDMA oxytocin levels as in the study design that showed a positive within-subject correlation after MDMA for oxytocin and prosocial effects…”
BackgroundResultInfluentialModulation of Social Cognition via Hallucinogens and “Entactogens”
Preller, K. H., & Vollenweider, F. X. (2019) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00881 · Cited by 71 · see citing works
Effects of MDMA on attention to positive social cues and pleasantness of affective touch
Bershad, A. K., Mayo, L. M., Hedger, K. V., McGlone, F. P., Walker, S. C., & de Wit, H. (2019) · Neuropsychopharmacology · doi:10.1038/s41386-019-0402-z · Cited by 73 · see citing works
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Atila, C., Holze, F., Murugesu, R., Rommers, N., Hutter, N., Varghese, N., Sailer, C. O., Eckert, A., Heinrichs, M., Liechti, M. E., et al. (2023) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(23)00120-1 · Cited by 64 · see citing works
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Prediction of MDMA response in healthy humans: a pooled analysis of placebo-controlled studies
Studerus, E., Vizeli, P., Harder, S., Ley, L., & Liechti, M. E. (2021) · Journal of Psychopharmacology · doi:10.1177/0269881121998322 · Cited by 53 · see citing works
“Our finding that the MDMA plasma concentration – and indirectly MDMA dose per body weight – is the most important predictor for the response to MDMA is in line previous dose-response studies (Bedi and de Wit, 2011; Harris et al., 2002; Kolbrich et al., 2008; Kuypers et al., 2017).”
ResultSelf-citationOeri, H. E. (2020) · Journal of Psychopharmacology · doi:10.1177/0269881120920420 · Cited by 41 · see citing works
“…of MDMA seems to be to increase cognitive and emotional empathy, while decreasing sensitivity to negative emotional stimuli and the ability to recognise negative emotions in others (Carhart-Harris et al., 2014; Doss et al., 2018; Frye et al., 2014; Hysek et al., 2012a; Kuypers et al., 2017, 2018a).”
BackgroundResultGabay, A. S., Kempton, M. J., Gilleen, J., & Mehta, M. A. (2018) · Journal of Neuroscience · doi:10.1523/jneurosci.1276-18.2018 · Cited by 40 · see citing works
“Kuypers et al. (2017) show that MDMA increased affective, but not cognitive, empathy.”
BackgroundResultSchmidt, A., Müller, F., Dolder, P. C., Schmid, Y., Zanchi, D., Liechti, M. E., & Borgwardt, S. (2017) · The International Journal of Neuropsychopharmacology · doi:10.1093/ijnp/pyx037 · Cited by 39 · see citing works
“This dose of MDMA is in the high range of the doses typically used in clinical research (Kirkpatrick et al., 2014; Kirkpatrick et al., 2015; Kuypers et al., 2017) and is within the dose range that is used recreationally (Brunt et al.”
Self-citationPsilocybin and MDMA reduce costly punishment in the Ultimatum Game
Gabay, A. S., Carhart-Harris, R. L., Mazibuko, N., Kempton, M. J., Morrison, P. D., Nutt, D., & Mehta, M. A. (2018) · Scientific Reports · doi:10.1038/s41598-018-26656-2 · Cited by 37 · see citing works
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Self-citationMDMA-Induced Dissociative State not Mediated by the 5-HT2A Receptor
Puxty, D. J., Ramaekers, J. G., de la Torre, R., Farré, M., Pizarro, N., Pujadas, M., & Kuypers, K. P. C. (2017) · Frontiers in Pharmacology · doi:10.3389/fphar.2017.00455 · Cited by 31 · see citing works
“, emotional empathy and prospective memory) (Ramaekers et al., 2009; Kuypers et al., 2017), it would be relevant to explore the relation between MDMA concentrations and the dissociative state.”
BackgroundSelf-citationMolla, H. M., Lee, R., Lyubomirsky, S., & de Wit, H. (2023) · Scientific Reports · doi:10.1038/s41598-023-43156-0 · Cited by 30 · see citing works
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“The MET is a well-established task that has been widely used in the study of healthy subjects (Hysek et al., 2014; Ze et al., 2014; Kuypers et al., 2017) and of those with various psychiatric disorders, including patients diagnosed with schizophrenia (Lehmann et al.”
BackgroundKerr‐Gaffney, J., Harrison, A., & Tchanturia, K. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.01.169 · Cited by 29 · see citing works
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Pharmacological effects of methylone and MDMA in humans
Poyatos, L., Pérez‐Mañá, C., Hladun, O., Núñez-Montero, M., de la Rosa, G., Martín, S., Barriocanal, A. M., Carabias, L., Kelmendi, B., Taoussi, O., et al. (2023) · Frontiers in Pharmacology · doi:10.3389/fphar.2023.1122861 · Cited by 27 · see citing works
Acute Effects of Methylphenidate, Modafinil, and MDMA on Negative Emotion Processing
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“…empathy) to positive interpersonal situations and emotional expressions of others (Bedi et al., 2009; Hysek et al., 2014; Jungaberle et al., 2018; Kuypers et al., 2017; Wardle & De Wit, 2014; Wardle et al., 2014) may make therapist expressions of positive emotion such as compassion and liking…”
BackgroundWunderli, M. D., Vonmoos, M., Treichler, L., Zeller, C., Dziobek, I., Kræmer, T., Baumgartner, M. R., Seifritz, E., & Quednow, B. B. (2017) · The International Journal of Neuropsychopharmacology · doi:10.1093/ijnp/pyx098 · Cited by 22 · see citing works
MDMA-assisted psychotherapy for PTSD in adolescents: rationale, potential, risks, and considerations
Kangaslampi, S., & Zijlmans, J. (2023) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-023-02310-9 · Cited by 23 · see citing works
Psychedelics and Psychedelic-Assisted Psychotherapy
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“The exact role of oxytocin on the prosocial effects of MDMA is less clear, however, as some studies have found it to be unrelated to empathy (Kuypers et al., 2017).”
BackgroundMethodInfluentialKey interindividual determinants in MDMA pharmacodynamics
Papaseit, E., Torrens, M., Pérez‐Mañá, C., Muga, R., & Farré, M. (2018) · Expert Opinion on Drug Metabolism & Toxicology · doi:10.1080/17425255.2018.1424832 · Cited by 20 · see citing works
“The larger analysis also including the previous smaller dataset [14] found similar MDMA-induced increases in empathy in men and women [39] and thus no sex differences in the empathogenic effects of MDMA.”
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“1186/1471-2210-6-6 PMID: 16515684 [184] Kuypers, K.”
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“A pooled analysis of six placebo-controlled experiments found that MDMA increased emotional empathy—especially for positive emotions—but did not impact cognitive empathy [40].”
BackgroundBoxler, M. I., Liechti, M. E., Schmid, Y., Kræmer, T., & Steuer, A. E. (2017) · Journal of Proteome Research · doi:10.1021/acs.jproteome.7b00294 · Cited by 17 · see citing works
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“Similar effects have also been observed with exogenous administration of 3,4-methylenedioxymethamphetamine (MDMA), commonly known as the recreational drug, ecstasy (125).”
BackgroundCouple Therapy With MDMA—Proposed Pathways of Action
Wagner, A. C. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.733456 · Cited by 15 · see citing works
Entactogen Effects of Ketamine: A Reverse-Translational Study
Hess, E. M., Greenstein, D. K., Hutchinson, O. L., Zarate, C. A., & Gould, T. D. (2024) · American Journal of Psychiatry · doi:10.1176/appi.ajp.20230980 · Cited by 14 · see citing works
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Self-citationA Review of MDMA-Assisted Therapy for Posttraumatic Stress Disorder
Lewis, B. R., & Byrne, K. (2023) · FOCUS The Journal of Lifelong Learning in Psychiatry · doi:10.1176/appi.focus.20220088 · Cited by 14 · see citing works
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Transcranial direct current stimulation for empathy: A systematic review and meta-analysis
Bahji, A., Forth, E., Yang, C., & Khalifa, N. R. (2021) · Social Neuroscience · doi:10.1080/17470919.2021.1889657 · Cited by 12 · see citing works
Social Psychopharmacology: Novel Approaches to Treat Deficits in Social Motivation in Schizophrenia
Bershad, A. K., & de Wit, H. (2023) · Schizophrenia Bulletin · doi:10.1093/schbul/sbad094 · Cited by 12 · see citing works
Kuypers, K. P. C., de la Torre, R., Farré, M., Xicota, L., Perna, E. B. D. S. F., Theunissen, E. L., & Ramaekers, J. G. (2018) · Scientific Reports · doi:10.1038/s41598-018-19618-1 · Cited by 12 · see citing works
Self-citationPsychoactive substances for the treatment of neuropsychiatric disorders
Zhen, Z., Sun, X., Yuan, S., & Zhang, J. (2024) · Asian Journal of Psychiatry · doi:10.1016/j.ajp.2024.104193 · Cited by 9 · see citing works
MDMA enhances positive affective responses to social feedback
Bershad, A. K., Hsu, D. T., & de Wit, H. (2024) · Journal of Psychopharmacology · doi:10.1177/02698811231224153 · Cited by 9 · see citing works
“…Bershad et al., 2019; Wardle and de Wit, 2014), emotion identification using static images or short morphed video clips of actors (Hysek et al., 2012; Wardle and de Wit, 2014), and reactivity to images with social content (Kuypers et al., 2014, 2017; Schmid et al., 2014; Wardle and de Wit, 2014).”
BackgroundKampka, N., Frommann, N., Henning, U., Schwark, R., Wölwer, W., Pietrowsky, R., & Luckhaus, C. (2018) · Journal of Neural Transmission · doi:10.1007/s00702-018-1955-4 · Cited by 9 · see citing works
A Systematic Review of the MDMA Model to Address Social Impairment in Autism
Chaliha, D. R., Mamo, J. C. L., Albrecht, M. A., Lam, V., Takechi, R., & Vaccarezza, M. (2021) · Current Neuropharmacology · doi:10.2174/1570159x19666210101130258 · Cited by 7 · see citing works
“Kuypers 2017 [155] NA Healthy 118 55 female, 63 male 21.”
Albert, A. E., & Back, A. L. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1529427 · Cited by 6 · see citing works
Dolder, P. C., Perna, E. B. D. S. F., Mason, N. L., Hutten, N. R. P. W., Toennes, S. W., Theunissen, E. L., Ramaekers, J. G., & Kuypers, K. P. C. (2018) · Human Psychopharmacology Clinical and Experimental · doi:10.1002/hup.2680 · Cited by 6 · see citing works
“Empathy trait scores of the current sample were comparable with those of a similar poly‐drug user sample (Kuypers et al., 2014) and with those of a sample of Dutch university students (Kuypers, 2017).”
ResultSelf-citationLevin, A. W. (2024) · Journal of Psychopharmacology · doi:10.1177/02698811241303599 · Cited by 5 · see citing works
“Finally, a pooled analysis of six placebo-controlled trials with MDMA ( N = 118) found that MDMA increased emotional empathy, at both doses, without affecting cognitive empathy (Kuypers et al., 2017).”
Neuroenhancement: State of the Art and Future Perspectives.
Marazziti, D., Avella, M. T., Ivaldi, T., Palermo, S., Massa, L., Vecchia, A. D., Basile, L., & Mucci, F. (2021) · PubMed Central · doi:10.36131/cnfioritieditore20210303 · Cited by 6 · see citing works
“Similarly, MDMA administration determined an increase in emotional empathy for positive emotionally charged situations of the MET, while this effect was low for negative emotions (Kuypers et al., 2017).”
BackgroundLima, F. F., Rossi, G. N., SANTOS, R. G. D., & Osório, F. D. L. (2023) · PLoS ONE · doi:10.1371/journal.pone.0284524 · Cited by 6 · see citing works
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MDMA – hopes and fears associated with therapeutic use in mental disorders
Kozera, K., Cichoń, L., Wilczyński, K. M., & Janas-Kozik, M. H. (2020) · Pharmacotherapy in Psychiatry and Neurology · doi:10.33450/fpn.2020.10.002 · Cited by 4 · see citing works
Methylone produces antidepressant-relevant actions and prosocial effects
Li, Z., Peng, H., Lee, C., Lin, T., Hsieh, M., Lai, C., Wu, H.-F., Chen, L., Chen, M.-C., & Chou, D. (2023) · Neuropharmacology · doi:10.1016/j.neuropharm.2023.109787 · Cited by 4 · see citing works
Rothärmel, M., Mékaoui, L., Kazour, F., Herrero, M., Beetz-Lobono, E.-M., Lengvenytė, A., Holtzmann, J., Raynaud, P., Cuenca, M., Bulteau, S., et al. (2024) · medRxiv · doi:10.1101/2024.01.09.24300998 · Cited by 4 · see citing works
“For instance, it enhances emotional empathy (Hysek et al., 2014; Kuypers et al., 2017), increases self-compassion (Kamboj et al., 2015) and has several pro-social effects (Bedi et al., 2009; Hysek et al., 2014) that could facilitate the therapeutic alliance and psychotherapeutic work.”
BackgroundRamaekers, J. G., Kuypers, K. P. C., & Vollenweider, F. X. (2026) · Molecular Psychiatry · doi:10.1038/s41380-026-03602-7 · Cited by 3 · see citing works
Self-citationAcute and Long-Term Effects of Ayahuasca on (Higher-Order) Cognitive Processes
Mason, N. L., & Kuypers, K. P. C. (2021) · Springer eBooks · doi:10.1007/978-3-030-55688-4_7 · Cited by 3 · see citing works
Self-citationKastner-Bosek, A., Dajic, I., Mikuš, N., Weidenauer, A., & Willeit, M. (2021) · Journal of Experimental Psychopathology · doi:10.1177/20438087211044362 · Cited by 3 · see citing works
“Serotonin has a beneficial effect on emotional empathy specifically, as amply demonstrated by studies using methylenedioxymethamphetamine (MDMA) and psilocybin, a naturally occurring psychedelic compound (Hysek et al., 2014; Kuypers et al., 2017; Preller et al., 2016).”
BackgroundJones, G. M., Lipson, J., & Wang, E. (2023) · Scientific Reports · doi:10.1038/s41598-023-29763-x · Cited by 2 · see citing works
MDMA for treatment of PTSD and neurorehabilitation in military populations
Dunn, W., Bershad, A. K., Krantz, D. E., & Vermetten, E. H. G. J. M. (2024) · Neurorehabilitation · doi:10.3233/nre-230270 · Cited by 2 · see citing works
“MDMA promotes cooperative behavior, generosity, and empathy (Gabay et al., 2019; Hysek et al., 2014; Kirkpatrick et al., 2015; Kuypers et al., 2017).”
MDMA (3,4-methylenedioxy-methamphetamine)
Krishnan, J. (2024) · BENTHAM SCIENCE PUBLISHERS eBooks · doi:10.2174/9789815223828124010004 · Cited by 1 · see citing works
A meta-analytic analysis of the acute effects of MDMA on empathy and emotion recognition in humans
Peled‐Avron, L., Aday, J. S., Pantoni, M. M., Hamilton, H., & Woolley, J. D. (2025) · Scientific Reports · doi:10.1038/s41598-025-25610-3 · Cited by 1 · see citing works
“Our findings are consistent with and extend prior work by Kuypers et al. 31 , who conducted a pooled subjects study to examine the effect of MDMA on empathy in this group.”
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Novel Mechanisms and Interventions for PTSD
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Drug and MDMA Interactions Implications for Public Health
Papaseit, E., Farré, M., & Pérez‐Mañá, C. (2022) · Springer eBooks · doi:10.1007/978-3-030-92392-1_121 · Cited by 1 · see citing works
Drug and MDMA Interactions Implications for Public Health
Papaseit, E., Farré, M., & Pérez‐Mañá, C. (2022) · Springer eBooks · doi:10.1007/978-3-030-67928-6_121-1
The good, the bad, and the intoxicated
Mason, N. L. (2021) · doi:10.26481/dis.20210608nm
Applications of MDMA in Modern Medicine - A Literature Review
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Psychedelics and Sexual Trauma: Effects on Communication and Emotional Connection
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“Larger-scale and controlled studies have shown mixed or null effects regarding gender differences (Kiraga et al., 2021; Kuypers et al., 2017; Mason et al., 2019).”
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Santé mentale et psychédéliques : révolution ou promesse utopique ?
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INTERVENTIONS AND TREATMENT FOR THE EFFECTS OF ACEs
Riley, D., & Pates, R. M. (2026) · doi:10.1002/9781394282432.ch13
Shared effects of the opioid antagonist naltrexone on first-hand and empathic pain
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“2014; Kuypers et al .”
Meijer, T. L., van Opdorp, A., & Markus, W. (2026) · Psychedelics · doi:10.1016/j.psyche.2026.100014
Mason, N. L., Mallaroni, P., Kuypers, K. P. C., de la Torre, R., Reckweg, J. T., Preller, K. H., & Ramaekers, J. G. (2026) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.64898/2026.08.04.742704
Self-citation
- Authors
- Kuypers, K. P., Dolder, P. C., Ramaekers, J. G., & Liechti, M. E.
- Affiliations
- Maastricht University (NL)
- University of Basel (CH)
- Corresponding author
- Kuypers, Kim PC
- Venue
- Journal of Psychopharmacology
- Publisher
- SAGE Publications
- Published
- 2017-04-03
- Volume
- 31
- Issue
- 5
- Pages
- 589-598
- ISSN
- 0269-8811 (ISSN-L)
- 1461-7285
- PMC
- PMC5418931
- OpenAlex
- W2604124685
- Cited by
- 89
- References
- 29
- Citations by year
- 2026: 8 · 2025: 6 · 2024: 9 · 2023: 10 · 2022: 4 · 2021: 15 · 2020: 7 · 2019: 8 · 2018: 13 · 2017: 9
- FWCI
- 12.55
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Journal of Psychopharmacology (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion, cc-by-nc)
- edoc (University of Basel) (acceptedVersion)
- Research Publications (Maastricht University) (submittedVersion, cc-by-nc)
- edoc (University of Basel)
- Funders
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (320030_149493 and 320030_170249)
- Nederlandse Organisatie voor Wetenschappelijk Onderzoek (400-07-2013)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychedelics and Drug Studies
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Health Sciences › Medicine › Psychiatry and Mental health › Empathy and Medical Education
- Keywords
- MDMA, ecstasy, affective empathy, cognitive empathy, oxytocin, trait empathy, Interpersonal Reactivity Index, sex differences, drug use history, positive and negative emotions, acute drug effects
- MeSH terms
- Adult, Double-Blind Method, Emotions, Empathy, Female, Hallucinogens, Humans, Interpersonal Relations, Male, Oxytocin, Social Behavior, N-Methyl-3,4-methylenedioxyamphetamine, Young Adult, Healthy Volunteers
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