Acute effects of MDMA on trust, cooperative behaviour and empathy: A double-blind, placebo-controlled experiment

Abstract

Background: 3,4-Methylenedioxymethamphetamine (MDMA) is being actively researched as an adjunct to psychotherapy. It may be beneficial to trust, empathy and cooperative behaviour due to its acute prosocial effects. Aim: To test (a) the acute effects of MDMA on measures of empathy, trust and cooperative behaviour, and (b) subacute changes in mood three days after MDMA administration. Methods: Twenty-five participants ( n=7 female), participated in this double-blind, repeated-measures, placebo-controlled experiment. Participants attended two acute sessions, one week apart. Each acute session was followed by a subacute session three days later. Participants received placebo (100 mg ascorbic acid) during one acute session, and MDMA (100 mg MDMA-HCl) at the other, with order counterbalanced. Participants completed the following tasks assessing prosocial behaviour: a trust investment task, a trustworthy face rating task, an empathic stories task, a public project game, a dictator game and an ultimatum game. Participants reported subjective effects. Blood was taken pre-drug, 2 and 4 hours post-drug, and tested for plasma MDMA levels. Results: MDMA acutely increased self-reported ‘closeness to others’ and ‘euphoria’ and increased plasma concentrations of MDMA. MDMA did not significantly change task-based empathy, trust or cooperative behaviour. Using Bayesian analyses, we found evidence that MDMA and placebo did not differ in their effects on empathy and cooperative behaviour. MDMA did not significantly change subacute mood and this was supported by our Bayesian analyses. Conclusion: Despite augmentation in plasma MDMA levels and subjective drug effects, we found no increase in prosocial behaviour in a laboratory setting.

Self-reported PTSD is associated with increased use of MDMA in adolescents with substance use disorders

“…Our results indeed show, that a higher prevalence of MDMA use is specifically related to the presence of the avoidance SC. Symptoms of the avoidance cluster include ‘feeling of detachment’ or ‘restricted range of affect’ which might be associated with MDMA use since MDMA has been shown to induce heightened empathy (Carlyle et al, 2019 ), increased pro-social behaviour (Borissova et al, 2020 ; Stewart et al, 2014 ) and is often used in social settings (McElrath & McEvoy, 2002 ). On the other hand, side effects of MDMA such as increased body temperature (Liechti, 2014 ) and increased blood pressure (Vizeli & Liechti, 2017 ) might explain why MDMA use is not associated with hyperarousal, since the increased activation of the sympathetic nervous system might exacerbate negative aspects of hyperarousal.…”

Couple Therapy With MDMA—Proposed Pathways of Action

“…MDMA has also demonstrated a reduction in anxiety in therapeutic contexts (e.g., Danforth et al, 2018 ). Evidence demonstrates that MDMA enhances feelings of closeness to others (Borissova et al, 2020 ), which is particularly useful in couple therapy to allow the individuals to feel connected within the experience, regardless of content being shared. In couple therapy, facilitating the sharing of emotional content leads to improved closeness and satisfaction (e.g., Sanford, 2007 ; Christensen et al, 2020 ).…”

Debunking the myth of ‘Blue Mondays’: No evidence of affect drop after taking clinical MDMA

“…This therefore can confound the effects of MDMA with those resulting from lack of sleep, exhaustion, dehydration and interactions with other psychoactive drugs (whether taken intentionally or inadvertently), which may account for some of the post-acute cognitive and affective changes documented by MDMA users. Nonetheless, Vollenweider et al (1998) reported that a third of healthy participants experienced slightly depressed mood during the 3 days after clinically administered MDMA compared with placebo, whereas another study that was placebo-controlled and examined healthy individuals found that clinically administered MDMA did not lead to changes in mood during the 3 days after dosing (Borissova et al, 2020).…”