MDMA's specific effect on social interactions provides a clue for understanding empathy.

“The primary mechanism of MDMA is serotonin release, and to a degree, other monoamine release, dopamine serotonin.”

“MDMA is a unique compound in that it leads to very large increases in the amount of both Dopamine and Serotonin in the brain and body simultaneously. And that's a unique circumstance that is just simply not seen under normal conditions.”

“Now, the Dopamine increases are generally what lead to the feelings of euphoria inside of the MDMA session. And then the Serotonin increases it is thought are what lead to the feelings of safety and comfort.”

“here's a really key point the increases in serotonin that MDMA creates are at least three times and maybe as much as eight times greater than the amount of dopamine released that MDMA causes”

“the fact that serotonin and dopamine are released together has distinctly different effects than if just dopamine or just serotonin is increased”

“that combination of big increases in dopamine and big increases in serotonin are what lead to these highly unusual and yet what seem to be potentially clinically very beneficial effects of having people feel a lot of mood elevation and a lot of stimulation from the stimulant properties of the methamphetamine component”

“MDMA is increasing dopamine to increase motivation and to reward something what gets rewarded well what gets rewarded is the serotonin activation of particular brain networks associated with sociability”

“it really seems that the addition of this huge release of Serotonin by MDMA on top of the release of dopamine sets in motion two parallel circuits one for rewarding something anything that's the dopamine component and then fortunately because the increase in serotonin caused by MDMA increases empathy and sociability for and with others but also for oneself the motivation that's reinforced that's wired into the brain seems to be a motivation to perceive others as more kind but also to be kinder to oneself”

“produces big increases in dopamine and serotonin to create these highly motivated pro-social empathic States meaning both empathy for others and for self”

“the addictive liability is mostly, although not solely, being, mediated by its actions on the dopamine system, whereas its positive, more pro social effects and perhaps its empathogenic effects are more likely to be mediated by its interactions with the serotonin system in this reward circuitry.”

“there is no substance in nature, no plant, no mushroom, no ergot, no mold that creates this increase in dopamine and serotonin simultaneously.”

“How does a drug that has molecular targets in the dopamine neuromodulatory system, in the serotonin neuromodulatory system have such a powerful effect, which is relatively specific on social interactions?”

“So the MDMA that is used for clinical trials that MAPS, MDMA is a molecule, and it has mirror images of itself, and one has the name RMDMA and one has the name SMDMA, and they're called the enantiomers because they're mirror images of each other and other labs over the years, not my lab, I deserve no credit for this, have done some studies to suggest that the S enantiomer is the one that has a higher interaction with the dopamine system, and the R enantiomer has a higher interaction with the serotonin system.”

“It's not 50/50. Maybe it's 70/30, 80/20. And that's because the molecule itself of MDMA, again, I'm trying not to use language, it binds to, has a higher affinity, it likes to bind to and influence the serotonin vacuum cleaner more than the dopamine vacuum cleaner. It's still affecting both, but it's not 50/50. It's more, whatever, 70% serotonin, 30% dopamine.”

“MDMA dramatically increases serotonin and dopamine but it seems to be the serotonergic effect that um is responsible for most of its therapeutic effect”

“it is the increase in serotonin perhaps or at least it's now thought in addition to the increase in dopamine caused by the methampetamine component combined that provides some sort of neuroprotective effect”

“the problem with having that much serotonin and that much dopamine in your system is that you can become empathic toward anything”

“and in the case of oxytocin oxytocin directly what they basically concluded was that oxytocin has very little if anything to do with the Imp pathogenic aspects of um of MDMA”