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MDMA (3,4-Methylenedioxymethamphetamine)

Category: Psychedelics. Status: Schedule I (FDA Breakthrough Therapy for PTSD).

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.

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Research and educational reference only. Not medical advice.