How does MDMA affect prolactin?

MDMA is known to significantly increase prolactin levels. This increase can contribute to the "crash" or post-MDMA lethargy and lack of motivation, often experienced for several hours or days after MDMA ingestion. Prolactin is involved in various bodily functions, including milk production in lactating women and setting the refractory period for sexual arousal and ejaculation in males. The surge in prolactin following MDMA use is also linked to increases in feelings of fatigue and enhanced laying down of body fat stores.

To mitigate the increase in prolactin and its associated effects, some clinicians have begun exploring the use of P5P (a metabolite of vitamin B6), which is known to suppress prolactin levels. However, controlled clinical trials on this application are yet to be performed. This exploration highlights the significance of prolactin's increase in impacting the subjective effects experienced after MDMA usage, contrasting with other recovery measures like magnesium or L-tryptophan which are often recommended 1.