Rankings / Mood, Anxiety & Stress

MDMA (3,4-methylenedioxymethamphetamine)

Mood, Anxiety & Stress · Entactogen

Tier C

dopamineserotoninpsychedeliccontrolled-substance
5.1 / 10
Tier C
Ev 6 Bn 6.5 Sf 3.5

Bottom line

Read Off Label grades MDMA (3,4-methylenedioxymethamphetamine) as C (5.1/10) based on moderate evidence, med-high benefit magnitude, and a med-high-risk safety profile.

FDA rejected Lykos (formerly MAPS PBC) NDA for MDMA-AT in PTSD August 2024 — citing functional unblinding, trial design, and therapist sexual misconduct in Ph2.

Typical use: 80-125 mg PO in clinical protocols; recreational doses highly variable and often adulterated — Schedule I US; expanded access in Australia for PTSD.

What this is

FDA rejected Lykos (formerly MAPS PBC) NDA for MDMA-AT in PTSD August 2024 — citing functional unblinding, trial design, and therapist sexual misconduct in Ph2. Lykos required to run new Ph3. Pure MDMA vs street 'ecstasy' (often adulterated/contaminated) is a major harm-reduction issue.

Mechanism

Massive serotonin release via SERT reversal; also dopamine/norepinephrine release; oxytocin release; acute prosocial and empathogenic effects

Dose & route

80-125 mg PO in clinical protocols; recreational doses highly variable and often adulterated

Common questions

Does MDMA (3,4-methylenedioxymethamphetamine) work?
Read Off Label rates the evidence for MDMA (3,4-methylenedioxymethamphetamine) as Moderate and the benefit magnitude as med-high, producing an overall grade of C (5.1/10). FDA rejected Lykos (formerly MAPS PBC) NDA for MDMA-AT in PTSD August 2024 — citing functional unblinding, trial design, and therapist sexual misconduct in Ph2.
Is MDMA (3,4-methylenedioxymethamphetamine) safe?
MDMA (3,4-methylenedioxymethamphetamine) has a med-high risk profile in published human data. Legal status: Schedule I US; expanded access in Australia for PTSD. This is not medical advice — see the disclaimer.
What is the typical dose for MDMA (3,4-methylenedioxymethamphetamine)?
80-125 mg PO in clinical protocols; recreational doses highly variable and often adulterated
How does MDMA (3,4-methylenedioxymethamphetamine) work?
Massive serotonin release via SERT reversal; also dopamine/norepinephrine release; oxytocin release; acute prosocial and empathogenic effects

This is an independent synthesis of published research by a non-clinician. Scores are opinions supported by citations, not prescriptions. See the full disclaimer and methodology for how this score was produced and what it does and doesn't mean.