Definitions/Description

• MDMA is a substituted amphetamine that acts by promoting the release of serotonin, dopamine, and norepinephrine through reversal of their respective transporters (SERT, DAT, and NET).
• It was initially synthesized in 1912 by Merck but was not meaningfully studied in humans until it was resynthesized and characterized by Alexander Shulgin in 1965.
• It found limited use as a gray-market adjunct to psychotherapy, particularly couples therapy, before expanding into recreational use in the 1970s and 1980s. It was placed on Schedule I in 1985, where it remains today.
• It is primarily used as a recreational drug, known for typical amphetamine-like effects (increased arousal, mood, and energy) but is distinguished by its prosocial or empathogenic properties.
• In its recreational use, it is frequently called ecstasy or molly and is administered while listening to dance music.
• However, illicitly sold ‘ecstasy’ or ‘molly’ is frequently adulterated with other substances, including stimulants, synthetic cathinones, or adulterants, leading to variable effects and increased risk.