New research published in Journal of Psychopharmacology provides evidence that the drug MDMA, commonly known as ecstasy, may have the unique ability to enhance emotional responses to positive (but not negative) social interactions. This insight sheds light on the potential of MDMA to influence social perception, opening new avenues for understanding and potentially treating conditions characterized by impaired social processing.
MDMA, or 3,4-methylenedioxymethamphetamine, is a psychoactive drug primarily known for its recreational use due to its unique effects on emotion, perception, and sense of social connection. Unlike traditional stimulants, MDMA is classified as an “empathogen,” meaning it promotes feelings of empathy, emotional warmth, and an increased willingness to socialize. Its pharmacological action is characterized by the release of neurotransmitters such as serotonin, dopamine, and norepinephrine, with a notable emphasis on serotonin.
Beyond its recreational popularity, MDMA has attracted attention from the medical community for its potential therapeutic benefits, particularly as an adjunct to psychotherapy for treating post-traumatic stress disorder (PTSD) and other mental health conditions.
The necessity for this study stems from the critical role of social processing in human mental health and the lack of effective pharmacological treatments for social processing impairments across various psychiatric disorders. Deficits in processing social feedback can significantly impact an individual’s ability to maintain healthy relationships and function effectively in society, contributing to the severity of conditions like autism, mood disorders, and schizophrenia.
“MDMA is known as a ‘prosocial’ compound, and there is accumulating evidence that it works to enhance psychotherapy in the treatment of PTSD,” said study author Anya Bershad, an assistant professor of psychiatry at UCLA. “Yet little is known about how the drug actually affects the way individuals experience social interactions. We wanted to test the effects of the drug on one discrete component of the social interaction by asking the question, how does MDMA affect mood when individuals are explicitly told they are liked or disliked by another person?”
To investigate the effects of MDMA on social processing, Bershad and her colleagues conducted a double-blind, placebo-controlled crossover trial. Participants consisted of 36 healthy volunteers, aged 18 to 40, with previous MDMA use, ensuring some familiarity with the drug’s effects. This group underwent a thorough screening process, including psychiatric interviews and physical exams, to rule out current psychiatric disorders or serious medical conditions.
Over the course of the study, each participant attended four separate sessions, during which they completed a social feedback task after being administered a single dose of either a placebo, MDMA at one of two doses (0.75 mg/kg or 1.5 mg/kg), or methamphetamine (20 mg), in randomized order. This design allowed the researchers to compare the effects of different doses of MDMA against both a non-active placebo and an active stimulant drug, providing a clear picture of MDMA’s specific impacts on social processing.
The social feedback task, a central component of the study, was designed to simulate social interactions in a controlled laboratory setting. Participants initially created online profiles and selected profiles of others they were interested in forming a connection with, based on photographs and brief descriptions. During the drug sessions, they received feedback indicating whether the individuals they selected liked them (social acceptance) or did not like them (social rejection).
The researchers found that participants who received higher doses of MDMA reported significantly increased feelings of happiness and acceptance when receiving positive social feedback compared to those given a placebo. This enhancement of positive social emotions underscores MDMA’s potential to influence social interactions favorably, aligning with its empathogenic properties that promote feelings of closeness and empathy towards others.
“The important take-away from this study is that we’ve shown that MDMA helps people feel more positively about receiving social feedback,” Bershad told PsyPost. “This could be one way the drug acts to facilitate social connection and therapeutic rapport in the context of psychotherapy.”
Interestingly, Bershad and her colleagues did not observe a significant reduction in negative affective responses to social rejection with MDMA administration, which challenges some previous assumptions about the drug’s ability to dampen negative social emotions. This suggests that while MDMA can amplify positive social experiences, its impact on negative emotions in social contexts may be more nuanced or limited under certain conditions.
The comparison drug, methamphetamine, did not show significant effects on social emotional responses, highlighting the unique action of MDMA in the social domain. Unlike methamphetamine, which shares some stimulant properties with MDMA, the latter’s distinct impact on positive social feedback suggests a specific mechanism through which MDMA enhances social processing. This differentiation is crucial, pointing towards MDMA’s potential therapeutic applications that go beyond the general stimulant effects seen with other amphetamines.
“One important thing to keep in mind is that while our findings may have implications for the clinical use of MDMA, they also suggest a way in which the drug may make individuals particularly vulnerable,” Bershad noted. “Increasing positive mood in response to social feedback could facilitate therapeutic alliance on the one hand, but on the other it may put individuals at risk of being taken advantage of in certain social contexts.”
The study’s findings pave the way for future research to delve deeper into the mechanisms underlying MDMA’s prosocial effects and its potential integration into psychotherapeutic settings to improve social connectivity and emotional well-being.
“We hope to continue to study the specifics of how MDMA affects social perception and behavior and to use this information to understand which types of psychotherapeutic techniques may be most effectively used with the drug in clinical settings,” Bershad said.
The study, “MDMA enhances positive affective responses to social feedback,” was authored by Anya K. Bershad, David T. Hsu, and Harriet de Wit.
