Methylenedioxymethamphetamine

MDMA

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Methylenedioxymethamphetamine ballicule: receptor binding, kinetics and half-life diagram — Mechanism of action: Methylenedioxymethamphetamine ballicule

Methylenedioxymethamphetamine MDMA mascot mnemonic cartoon — Visual mnemonic: Methylenedioxymethamphetamine mascot
**“My dome of feta”**

What it isSerotonin, norepinephrine and dopamine releaser; investigational for PTSD.

Why this oneIts prosocial and fear-attenuating effect is the rationale for psychotherapy-assisted use.

What limits it⚑ Hyperthermia and hyponatremia cause the deaths, not the drug’s direct toxicity. Serotonin syndrome with MAOIs; FDA declined approval in 2024.

Methylenedioxymethamphetamine molecular structure (skeletal formula) — Molecular structure: Methylenedioxymethamphetamine

FDA-approved for

PTSD (investigational; not approved)

Off-label

PTSD (phase 3; FDA declined approval in 2024)

NO BOXED WARNINGS

Principal risk⚑ Hyperthermia and hyponatremia cause the deaths, not the drug’s direct toxicity

Classes and tags

Clinical profile

Direct muscarinic antagonism0 / 4

Serotonin and MAOI

Provisional washout figures

SRI significance0 / 4

Serotonin release4 / 4

Elevating mechanismSerotonin releaser (SERT substrate)

Evidence confidenceHigh

InterpretationA SERT SUBSTRATE, not a reuptake blocker: it is carried into the neuron and reverses the transporter. Citalopram 40 mg IV markedly reduced MDMA's psychological effects in humans (Liechti 2000), so an SSRI ATTENUATES it rather than adding to it. The MAOI hazard is real and sits on the release axis -- MAO-A inhibition cannot stop the carrier running backwards.

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Memory aids: interaction avatars

CYP2D6 inhibitor (strong)

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