J Psychoactive Drugs. 2014 Jan-Mar;46(1):37-43. doi: 10.1080/02791072.2014.873690.
MDMA has properties that may make it attractive for psychotherapy, although many of its effects are potentially problematic. These contrasting effects will be critically reviewed in order to assess whether MDMA could be safe for clinical usage. Early studies from the 1980s noted that MDMA was an entactogen, engendering feelings of love and warmth. However, negative experiences can also occur with MDMA since it is not selective in the thoughts or emotions it releases. This unpredictability in the psychological material released is similar to another serotonergic drug, LSD. Acute MDMA has powerful neurohormonal effects, increasing cortisol, oxytocin, testosterone, and other hormone levels. The release of oxytocin may facilitate psychotherapy, whereas cortisol may increase stress and be counterproductive. MDMA administration is followed by a period of neurochemical recovery, when low serotonin levels are often accompanied by lethargy and depression. Regular usage can also lead to serotonergic neurotoxicity, memory problems, and other psychobiological problems. Proponents of MDMA-assisted therapy state that it should only be used for reactive disorders (such as PTSD) since it can exacerbate distress in those with a prior psychiatric history. Overall, many issues need to be considered when debating the relative benefits and dangers of using MDMA for psychotherapy.
MDMA 具有一些可能使其成为心理治疗有吸引力的特性，尽管其许多影响可能存在问题。为了评估 MDMA 是否可安全用于临床，将对这些对比效应进行批判性审查。20 世纪 80 年代的早期研究指出，MDMA 是一种致幻剂，能产生爱和温暖的感觉。然而，由于 MDMA 释放的思想或情绪没有选择性，因此也可能会产生负面体验。这种在释放的心理物质方面的不可预测性类似于另一种血清素能药物 LSD。急性 MDMA 具有强大的神经激素作用，会增加皮质醇、催产素、睾丸激素和其他激素水平。催产素的释放可能有助于心理治疗，而皮质醇可能会增加压力，适得其反。MDMA 给药后会经历神经化学恢复阶段，此时通常伴随着低血清素水平、嗜睡和抑郁。常规使用也可能导致血清素能神经毒性、记忆问题和其他心理生物学问题。MDMA 辅助治疗的支持者指出，它只能用于反应性障碍（如 PTSD），因为它会加重有先前精神病史的人的痛苦。总的来说，在辩论使用 MDMA 进行心理治疗的相对益处和危险时，需要考虑许多问题。
