How does MDMA affect neurotransmitters?

MDMA impacts neurotransmitters primarily by interacting with the serotonin and dopamine systems. Specifically, MDMA strongly activates the serotonin 1B receptor, enhancing neural circuits related to trust and social engagement, incentivizing social interaction, and a desire to bond. This effect is paired with increased dopamine, which heightens motivation and the intensity of these desires 1.

Additionally, MDMA prevents the reuptake of dopamine at synapses, meaning it doesn't just stop the release of dopamine, but it blocks the process that would usually remove dopamine from the synaptic space. This action leads to higher dopamine levels in the synapse, which significantly increases dopaminergic tone and drive 2.

Moreover, MDMA’s effects are not solely about increasing dopamine; it also significantly boosts serotonin levels. It prevents the reuptake of serotonin in a similar way to dopamine, allowing more serotonin to remain in the synaptic space and enhance its effects. This combination of increased dopamine and serotonin levels contributes to MDMA's unique empathogenic properties, making it a subject of interest for therapeutic uses, particularly in treating PTSD 2.