Beyond the empathogen label: the social-affective profile of MDMA
Abstract
<p>3,4-methylenedioxymethamphetamine (MDMA) is widely described as an “empathogen”, yet empathy is not a unitary process. Here we review MDMA’s social effects by decomposing them into social perception and emotion discrimination, sociability and social reward, affective sharing, cognitive empathy and mentalizing, and prosocial behaviour. Available evidence gathered in humans and other mammals demonstrate that MDMA has distinct effects across these domains, although research coverage remains uneven across domains. We argue that MDMA is best understood not as a global empathy enhancer, but as a domain-specific modulator of social reward, threat perception, positive-valence affective sharing, and interpersonal appraisal. Moving beyond this simplified empathy enhancer concept is essential for understanding both the therapeutic promise and the interpersonal risks of MDMA.</p>
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