MDMA Changes the Brain — But Scientists Still Don’t Know Its Full Potential

Just like shoulder pads and bleached tips, drugs fall in and out of fashion with the scientific and medical establishment. And perhaps none is having such a renaissance moment as MDMA. Whether you call it ecstasy, molly, or even just “E,” MDMA is very likely to be legally approved to treat post-traumatic stress disorder in the United States by the country’s top medical authority, the Food and Drug Administration, by the end of 2024.

It’s a welcome if perhaps overdue move. Study after study shows MDMA can be used as a powerful therapeutic drug, and it may even treat other brain conditions, like anxiety and eating disorders.

At this point, the evidence trail stretches back years. The drug does something profound to our brains beyond inducing the classic euphoria that helped it garner the name “ecstasy.” In an interview with Inverse, science journalist Rachel Nuwer says that in all her reporting on the science of MDMA and how it changes the brain, it became increasingly obvious that it may open what’s known as a “critical period” in the brain — a pathway for the person to form new ways of thinking, almost like a return to a childhood state. Applied to trauma or triggers, this effect could ultimately be healing.

“It seems like the opportunities ... are almost infinite.”

“I think we’re just now beginning to approach those answers for MDMA and understand what it’s actually doing in the brain,” Nuwer explains. One major theme is that MDMA stimulates serotonin — a chemical transmitter in the body and brain that is associated with feelings of love toward other people.

In turn, society’s view of the drug is evolving, too. In her latest book, I Feel Love: MDMA and the Quest for Connection in a Fractured World, Nuwer contends that to maximize MDMA’s potential, we need a clearer understanding of the drug’s effect on the brain. She also explores some of the biggest and most ingrained myths about the drug — like anecdotes suggesting some people fall into a deep depression after using MDMA.

“When you get sad after taking MDMA, that’s probably because you’ve been partying all night and being hard on your body,” she says. Instead, MDMA’s effects are more complicated. Throughout the book, Nuwer cites evidence of MDMA’s healing power, but she’s also realistic about what science, so far, can tell us.

“Over the past forty-five years, MDMA has ricocheted from celebrated therapeutic catalyst to vilified illicit substance, from the world’s favorite party drug to federally designated breakthrough therapy,” she writes. Ultimately, MDMA is not a panacea. But it is certainly transformational.

Inverse spoke to Nuwer about how MDMA changes the brain, profound testimonies of its effects, and what happens when you give drugs to octopuses.

In the interview below, which has been edited and condensed for clarity, Nuwer expands on this catalyst for meaningful connection and how it’s become a “signifier of a possible world.”

How did reporting on MDMA and writing I Feel Love change your perceptions of MDMA?

I actually had not done that much journalistic work on MDMA before starting this book. I’m a science journalist, but my beat is mostly ecology, conservation, and illegal wildlife trade. I was kind of tired of being pigeon-holed as a “dead animal person,” and I wanted to learn something new.

But I had preconceptions [about MDMA] growing up. I thought ecstasy was this horrible drug that made you act crazy and then cast you into a deep depression. I had the preconception that some users fall into that hole afterward. I was surprised to learn that the research doesn’t stand up to that.

For example, in trials of MDMA-assisted therapy for PTSD, they did not see that happening. Instead, when you get sad after taking MDMA, that’s probably because you’ve been partying all night and being hard on your body. That said, I don’t discount people’s anecdotal experiences of feeling that way, and it’s not to say the experience never happens — I was just surprised to learn that there isn’t any research supporting it because it’s such a commonly reported phenomenon among recreational users.

In the book, you discuss how in the late 1970s and early 1980s therapists were interested in the drug’s therapeutic potential. Did people then know how MDMA works? Or was it more “Wow, it’s working, and we don’t know why.”

It was the latter, for sure. People had no idea why it worked or what it was doing. In the book, I make the comparison to penicillin: For decades, doctors used penicillin and saved lives with it, and it was hailed as a sort of miracle cure for bacterial infections. But nobody knew how it was actually squashing those infections until years later when scientists discovered the mechanism of action.

I think we’re just now beginning to approach those answers for MDMA and understand what it’s actually doing in the brain. There’s a study I cite about the “critical period” in the book, and it’s actually coming out in a couple of weeks. I’m looking forward to hearing what scientists have to say about that work and seeing if it holds up to replication and further testing.

“At their base root, [classic psychedelics] are pretty much doing the same thing to the brain. They are reopening that critical period.”

If it does, then that’s a really interesting discovery and one that potentially has so many other applications for different types of therapy — not just for mental health, but for stroke or restoring eyesight and hearing.

[“Critical periods” refer to a stage of development when the brain is more receptive to learning a behavior. Early studies suggest drugs like MDMA can reopen this window, causing the brain to act more childlike. This may explain why MDMA can help the brain relearn how to deal with certain sensory and informational cues, like a trauma trigger.]

You report on a therapeutic video game for stroke called I Am Dolphin and the research into using MDMA with the game to reopen the “motor learning critical period.” Why is it such a hopeful therapeutic for so many conditions?

It’s really cool. Gül Dölen’s [an associate professor of neuroscience at Johns Hopkins University] findings are that it’s not just MDMA that can do this — it’s pretty much all the classic psychedelics she’s tested so far. It appears that, at their base root, all of these drugs are pretty much doing the same thing to the brain. They are reopening that critical period.

“People joke that we should just put MDMA into the water and everyone would just love one another.”

Another fascinating thing about Dölen’s work is that she’s finding that this doesn’t just happen immediately — you have to prime the brain to reopen whichever critical period you’re targeting. So in the case of addressing trauma, that priming could be talk therapy, or in the case of stroke, it could be a tool like I Am Dolphin. If she’s right, and it does work this way, it seems like the opportunities for reopening critical periods are almost infinite.

Is it fair to say MDMA is helping scientists understand the brain? I’m thinking about Dölen’s octopus-MDMA experiments and how they suggest the brain’s been primed for social connections.

Yes, absolutely. The octopus experiment was so fascinating to me, and that was made possibly specifically because of MDMA. It elucidated that serotonin does have this super ancient role in mediating social behavior that goes way, way back — before mammals even arrive on the scene. I find it fascinating, and it adds to what we know about our own evolutionary journey and what we share with other species.

In the book, you share an MDMA user called Brendan’s story. He got MDMA as part of a study, but before that — and unbeknownst to the scientists — he led a white nationalist group. His post-MDMA realization that “love is the most important thing” is complicated, and he still holds some bigoted ideology. How did you feel after that interview?

I had really complicated feelings about that too. It was a difficult interview to do and also difficult to figure out how to write about it. That was another instance where I kind of came into this with preconceived notions. You know, people joke that we should just put MDMA into the water and everyone would just love one another. But real-world anecdotes, and what we know about MDMA, serotonin, and oxytocin don’t stand up to that.

I think Brendan’s story is a good case study that demonstrates that, too. Here’s someone who had this really harmful ideology, who was a leader in the alt-right movement, but was doxxed. So when he came to the MDMA experience, he was already a bit primed to be reflecting on his actions — what had landed him in this predicament where he lost his job. He lost all his friends; his family was ostracizing him. So it’s not like Brendan just showed up as an alt-right leader, took some MDMA, and had this profound realization that maybe what he was doing wasn’t great. He was already primed to have that realization and I think the MDMA nudged him in the direction he was leaning toward, at least subconsciously.

“This feeling that MDMA produces is why so many people keep returning to this drug.”

Yet it’s still true to say that it changed his life. I think he is sincere in saying that. The guy who outed him also agreed that there’s been a change in Brendan since he had his MDMA experience. But like you pointed out, it didn’t rid him of all these beliefs he had. I think that also comes back to what MDMA can and can’t do. It does not magically cure you of your problems.

For example, if you are using MDMA to address your trauma, you are still going to have the same issues you did before — but maybe now you can evaluate, approach, and react to them in different ways. That’s what Brandon is doing now; he’s trying to work on himself and address those underlying thoughts. The MDMA is a starting point but he still has a lot of work to do. That’s why integration — follow-ups with a therapist where you talk about what you learned and ways you can integrate those lessons into your life — is so important.

Dölen comments it’s important that people aren’t just taking MDMA for mental health and then returning to their normal lives. What should the future of this type of therapy be?

I think a lot of people may be disappointed with the results if they come to this hoping that they can just sit for one day of therapy, come out, and have their life completely changed. The work after is important, and integration is key. If you’re returning to whatever atmosphere contributed to your trauma in the first place, the MDMA is not going to make it go away.

I do think it can help people on an individual level, especially people who are willing to do the work afterward using integration because MDMA-assisted therapy is a touchstone for finding some kind of better place mentally. But it’s not going to solve the world’s problems.

It sounds a lot like traditional psychotherapy. One session isn’t going to help very much.

Yes, like psychotherapy, it’s not going to fix all your problems. But it can help you navigate them better.

One scientist you spoke with comments that almost everyone associates MDMA with love. Did that influence the title the book?

I actually came up with the title before I wrote the book proposal. I was on MDMA when I had the idea to write a book on MDMA. It was during the pandemic and my pod was having a tiny house party — it was just the three of us. Our friend had put together this disco playlist and Donna Summer’s “I Feel Love” was one of the songs. I was sitting on the couch and listening to it and I thought, “Oh, my God! I think I should write a book about MDMA and the book should be called I Feel Love.”

And love comes up as a through line in your reporting.

Totally. My editor was even hesitant about the title — at first, he was worried it referred too much to that party or it made the book not seem serious or science-y enough. But I knew it was going to work on so many different levels. It speaks to MDMA and the party scene, but it also speaks to MDMA and therapy. This feeling that MDMA produces is why so many people keep returning to this drug. It is such a beautiful feeling.

Rachel Nuwer is the author of I Feel Love: MDMA and the Quest for Connection in a Fractured World, published by Bloomsbury.