Entactogens, also known as empathogens or connectogens, are a class of psychoactive drugs that induce the production of experiences of emotional communion, oneness, connectedness, emotional openness—that is, empathy—as particularly observed and reported for experiences with MDMA.[1][2][3][4][5] This class of drug is distinguished from the classes of hallucinogens or psychedelics and stimulants, although entactogens, for instance MDMA, can also have these properties.[1][5][6][7] Entactogens are used both as recreational drugs[8] and are being investigated for medical use in the treatment of psychiatric disorders, for instance MDMA-assisted therapy for post-traumatic stress disorder (PTSD).[9][10][11]
Notable members of this class include the methylenedioxyphenethylamines (MDxx) MDMA, MDA, MDEA, MDOH, MBDB, and methylone, the benzofurans5-APB, 5-MAPB, 6-APB, and 6-MAPB, the cathinonemephedrone, the 2-aminoindane MDAI, and the α-alkyltryptamines αMT and αET, among others.[1][3] Most entactogens are amphetamines, although several, such as αMT and αET, are tryptamines.[1][3] When referring to MDMA and its counterparts, the term MDxx is often used (with the exception of certain non-entactogen drugs like MDPV).
Entactogens act as serotonin releasing agents (SRAs) as their key action.[12][13][3][14][15] However, entactogens also frequently have additional actions, such as induction of dopamine and norepinephrine and serotonin5-HT2 receptoragonism, which contributes to their effects as well.[12][13][3][14][15] It is thought that dopamine and norepinephrine release provide additional stimulant, euphoriant, and cardiovascular or sympathomimetic effects, serotonin 5-HT2A receptor agonism produces psychedelic effects of variable intensity, and both dopamine release and serotonin 5-HT2 receptor agonism may enhance the entactogenic effects and be critically involved in allowing for the qualitative "magic" of these drugs.[12][13][3][14][15] Entactogens that simultaneously induce serotonin and dopamine release, for instance MDMA, are known to produce long-lasting serotonergic neurotoxicity[16][17][3] with associated cognitive and memory deficits as well as psychiatric changes.[18][19][20][21]
MDA and MDMA were both first synthesized independently in the early 1910s.[22] The psychoactive effects of MDA were discovered in 1930 but were not described until the 1950s, MDA and MDMA emerged as recreational drugs in the 1960s, and the unique entactogenic effects of MDMA were first described in the 1970s.[22][23][24][25][26] Entactogens as a unique pharmacological class depending on induction of serotonin release was established in the mid-1980s and novel entactogens such as MBDB were developed at this time and after.[1][5][6] Gordon Alles discovered the psychoactive effects of MDA,[25][26] Alexander Shulgin played a key role in bringing awareness to MDMA and its unique effects,[24] and Ralph Metzner[27][28][29] and David E. Nichols formally defined entactogens and established them as a distinct class of drugs.[1][5][6] Many entactogens like MDMA are controlled substances throughout the world.[30][31]
Entactogens are used as recreational drugs, including notably at raves.[8]
Medical
Psychiatrists began using entactogens as psychotherapy tools in the 1970s despite the lack of clinical trials.[32] In recent years, the scientific community has been revisiting the possible therapeutic uses of entactogens. Therapeutic models using MDMA have been studied because of its entactogenic properties.[33] This type of therapy would be applicable for treating a patient who was experiencing psychological trauma such as PTSD. Traumatic memories can be linked to fear in the patients which makes engaging with these memories difficult. Administration of an entactogen such as MDMA allows the patient to disconnect from the fear associated with the traumatic memories and engage in therapy.[33] MDMA acts by targeting the body's stress response in order to cause this therapeutic effect. In addition to reducing anxiety and a conditioned fear response, MDMA also reduces the avoidance of feelings.[33] Patients are then able to trust themselves and their therapist and engage with traumatic memories under the influence of MDMA.
Although the therapeutic effects of entactogens may be promising, drugs such as MDMA have the potential for negative effects that are counter productive in a therapy setting. For example, MDMA may make negative cognition worse. This means that a positive experience is not a guarantee and can be contingent on aspects like the setting and the patient's expectations.[34] Additionally there is no clear model of the psychopharmacological means for a positive or negative experience.[34] There is also a potential concern for the neurotoxic effects of MDMA on the fiber density of serotonin neurons in the neocortex. High doses of MDMA may cause potential depletion of serotonergic axons. The same effects may not be caused by lower doses of MDMA required for treatment, however.[35]
MDMA-assisted psychotherapy (MDMA-AT) is in late-stage clinical trials to treat PTSD as of 2025.[9][10][11]
The above table does not include atypical agents with some claimed entactogen-like effects, such as 2C-B[44][56][57] and 5-MeO-MiPT.[58]
Effects
Both terms adopted and used in naming the class of therapeutic drugs for MDMA and related compounds were chosen with the intention of providing some reflection of the reported psychological effects associated with drugs in the classification and distinguishing these compounds from classical psychedelic drugs such as LSD, mescaline, and psilocybin and major stimulants, such as methamphetamine and amphetamine.[4] Chemically, MDMA is classified as a substituted amphetamine (which includes stimulants like dextroamphetamine and psychedelics like 2,5-dimethoxy-4-methylamphetamine), which makes MDMA a substituted phenethylamine (which includes other stimulants like methylphenidate and other psychedelics like mescaline) by the definition of amphetamine. While chemically related both to psychedelics and stimulants, the psychological effects experienced with MDMA were reported to provide obvious and striking aspects of personal relatedness, feelings of connectedness, communion with others, and ability to feel what others feel—in short an empathic resonance is consistently evoked.[59] While psychedelics like LSD may sometimes yield effects of empathic resonance, these effects tend to be momentary and likely passed over on the way to some other dimension or interest. In contrast, the main characteristic that distinguishes MDMA from LSD-type experiences is the consistency of the effects of emotional communion, relatedness, emotional openness—in short, empathy and sympathy.[4]
Entactogens like MDMA show a much narrower margin of safety and greater toxicity in overdose than serotonergic psychedelics.[60] Whereas LSD and psilocybin have extrapolated human lethal doses relative to typical recreational doses of approximately 1,000-fold and 200-fold, respectively,[61] a reasonable estimated fatal dose of MDMA is only about 15 or 16times a single typical recreational dose.[60]
Entactogens like MDMA are serotonin releasing agents and hence are indirect agonists of serotonin receptors.[67][68][69] They produce entactogenic effects in animals such as increased prosocial behavior like adjacent lying, enhanced empathy-like behavior, and antiaggressive effects.[67][70][12] Likewise, MDMA increases sociability, prosociality, and emotional empathy in humans.[12]
In animals, MDMA induced prosocial behavior and elevations in circulating oxytocin levels and these effects were abolished by pretreatment with the serotonin 5-HT1A receptorantagonistWAY-100635.[67][71][72][73][74] Conversely, the serotonin 5-HT1A receptor agonist 8-OH-DPAT produced prosocial behavior and increased oxytocin levels similarly to MDMA.[67][72][75] In addition, MDMA has been shown to activate oxytocinergic neurons in the hypothalamus and this too is reversed by serotonin 5-HT1A receptor antagonism.[67][72][76] Subsequent research found that direct injection of the serotonin 5-HT1A receptor WAY-100635 locally into the basolateral amygdala (BLA) suppressed MDMA-induced prosocial behavior and that direct injection of MDMA locally into the BLA significantly increased sociability.[77][73]
The serotonin 5-HT2B and 5-HT2C receptor antagonist SB-206553 has also been found to block MDMA-induced prosocial behavior, although it produced potentially confounding thigmotaxis (hyperactivity at periphery of testing chamber) as well.[71][74] Conversely, the serotonin 5-HT1B receptor antagonist GR-55562 and the serotonin 5-HT2A receptor antagonist ketanserin were both ineffective.[71][73][74] Likewise, another study found that selective antagonists of the serotonin 5-HT1B, 5-HT2A, 5-HT2C, and 5-HT4 receptors (SB-216641), volinanserin (MDL-100907), SB-242084, and SB-204070, respectively) were all ineffective in suppressing MDMA-induced prosocial activity.[77][73] Other research has found that serotonin 5-HT2B receptor inactivation abolishes the serotonin release induced by MDMA and attenuates many of its effects.[68][69][78] In addition to the preceding findings, induction of serotonin release by MDMA in the nucleus accumbens and consequent activation of serotonin 5-HT1B receptors in this area is implicated in its enhancement of prosocial behaviors, whereas consequent activation of yet-to-be-determined serotonin receptors in this area is implicated in its enhancement of empathy-like behaviors.[1][70][79][80] Injection of the serotonin 5-HT1B receptor antagonist NAS-181 directly into the nucleus accumbens blocked the prosocial behaviors of MDMA.[79]
On the basis of the serotonin 5-HT1A receptor-mediated oxytocin release with MDMA, it has been proposed that increased oxytocinergic signaling may mediate the prosocial effects of MDMA in animals.[67][72] Accordingly, intracerebroventricular injection of the peptide oxytocin receptor antagonist tocinoic acid blocked MDMA- and 8-OH-DPAT-induced prosocial effects.[67][72][81] However, in a subsequent study, systemically administered C25, a non-peptide oxytocin receptor antagonist, failed to affect MDMA-induced prosocial behavior, whereas the vasopressin V1A receptor antagonist relcovaptan (SR-49059) was able to block MDMA-induced prosocial activity.[67][81] It might be that tocinoic acid is non-selective and also blocks the vasopressin V1A receptor or that C25 is peripherally selective and is unable to block oxytocin receptors in the brain.[67][81] More research is needed to clarify this.[81][67] In any case, in another study, the non-peptide and centrally active selective oxytocin receptor antagonist L-368899 abolished MDMA-induced prosocial behavior.[81][82] Conversely, in other studies, different oxytocin receptor antagonists were ineffective.[79]
As in animals, MDMA greatly increases circulating oxytocin levels in humans.[67]Serotonin reuptake inhibitors and norepinephrine reuptake inhibitors reduced the subjective effects of MDMA in humans, for instance increased extroversion, self-confidence, closeness, openness, and talkativeness.[12] The 5-HT2A receptor antagonist ketanserin reduced MDMA-induced increases in friendliness.[12] MDMA-induced emotional empathy was not affected by the serotonin 5-HT1A receptor antagonist pindolol or by intranasal oxytocin.[83] Similarly, MDMA-induced emotional empathy and prosocial behavior have not been associated with circulating oxytocin levels.[83][67] As such, the role of oxytocin in the entactogenic effects of MDMA in humans is controversial.[67]
The serotonin release of MDMA appears to be the key pharmacological action mediating the entactogenic, prosocial, and empathy-enhancing effects of the drug.[12][13][3] However, in addition to serotonin release, MDMA is also a potentreleasing agent of norepinephrine and dopamine, and hence acts as a well-balanced serotonin–norepinephrine–dopamine releasing agent.[13][3] Additionally, MDMA is a direct agonist of several serotonin receptors, including of the serotonin 5-HT2 receptors, with moderate affinity.[13][3] These actions are thought to play an important role in the effects of MDMA, including in its psychostimulant, euphoriant, and mild psychedelic effects, as well as in its unique and difficult-to-replicate "magic".[13][14][3][94] It has been said by Matthew Baggott that few to no MDMA analogues, including MBDB, methylone, 6-APDB, 5-APDB, 6-APB, 5-APB, MDAT, and MDAI among others, reproduce the full quality and "magic" of MDMA.[14][15] Exceptions may anecdotally include 5-MAPB, particularly in specific enantiomer ratios, and the Borax combo.[14][15][95] The unique properties of MDMA are believed to be dependent on a very specific mixture and ratio of pharmacological activities, including combined serotonin, norepinephrine, and dopamine release and direct serotonin receptor agonism.[14][15]
Some entactogens, including the benzofurans5-MAPB, 6-MAPB, BK-5-MAPB, and BK-6-MAPB, have unexpectedly been found to be potent serotonin 5-HT1B receptor agonists.[96] In addition to serotonin release and other actions, this property may be involved may be involved in their entactogenic effects.[96] Conversely, MDMA is inactive as a direct agonist of the serotonin 5-HT1B receptor.[96]
Ariadne, the α-ethylanalogue of the serotonergic psychedelic DOM, fully substitutes for MDMA in rodent drug discrimination tests, suggesting that it may have entactogen-like effects.[97][98] This property is unusual among psychedelics, and is in notable contrast to DOM, which at best partially substitutes for MDMA.[98][99] Besides Ariadne, the NBOMe drugs such as 25I-NBOMe and 25B-NBOMe also partially to fully substitute for MDMA in rodents.[100][101][102][103] Unlike conventional entactogens, Ariadne shows no activity at the monoamine transporters, and instead acts as a selective serotonin 5-HT2 receptor partial agonist, including as a lower-efficacy agonist of the serotonin 5-HT2A receptor.[97] Certain other psychedelics and related compounds, like low doses of 2C-B, are also selective serotonin 5-HT2 receptor partial agonists that have likewise been implicated as having entactogenic effects.[44][56][57] MDMA itself is notable in being a lower-efficacy partial agonist of the serotonin 5-HT2A receptor as well.[104][105] The stimulus effects of MDMA in the drug discrimination paradigm are partially blocked by the selective serotonin 5-HT2A receptor antagonist volinanserin in rodents.[106] Similarly, the psychoactive effects of MDMA are partially blocked by the relatively selective serotonin 5-HT2A receptor antagonist ketanserin in humans.[13][107][108][109]
The term empathogen, meaning "generating a state of empathy", was coined by Ralph Metzner in 1983 as a term to denote a class of drugs that includes MDMA and other agents with similar effects.[27][28][29] Subsequently, in 1986, Nichols introduced the term entactogen, meaning "producing a touching within", to denote this class of drugs, asserting a concern with the potential for improper association of the term empathogen with negative connotations related to the Greek root πάθος páthos ("suffering; passion").[1][5][6] Additionally, Nichols wanted to avoid any association with the term pathogenesis.[112]
Nichols also thought the original term was limiting, and did not cover other therapeutic uses for the drugs that go beyond instilling feelings of empathy.[4] The hybrid wordentactogen is derived from the roots en (Greek: within), tactus (Latin: touch) and -gen (Greek: produce).[5] Entactogen is not becoming dominant in usage, and, despite their difference in connotation, they are essentially interchangeable, as they refer to precisely the same chemicals.
In 2024, an additional alternative term, connectogen, was proposed and introduced by Kurt Stocker and Matthias Liechti.[2]
↑ 4.04.14.24.3Cite error: Invalid <ref> tag; no text was provided for refs named NicholsYensenMetzner1993
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↑ 28.028.1Holland, J., ed (2001). "Using MDMA in Healing, Psychotherapy, and Spiritual Practice". Ecstasy: The Complete Guide: A Comprehensive Look at the Risks and Benefits of MDMA. Inner Traditions/Bear. pp. 182–207. ISBN978-0-89281-857-0. https://books.google.com/books?id=CUCcyklcO00C. "The term "empathogenic," meaning "generating a state of empathy," was independently proposed for these substances in 1983—84 by Ralph Metzner, a psychologist and psychopharmacologist, and David Nichols, a professor of medicinal chemistry at Purdue University. Nichols subsequently rejected the term and now prefers "entactogenic," meaning "touching within," for MDMA. We continue to use the term "empathogenic.""
↑ 29.029.1Ralph Metzner (May 1983). "[Lecture presented at the Psychedelics and Spirituality Conference"]. Psychedelics and Spirituality, University of California, Santa Barbara, May 13–14, 1983. https://scholar.google.com/scholar?cluster=16938435501563008121. "Another group of drugs are the phenethylamines, of which MDA [and MDMA] is an example. Instead of calling these "psychedelic drugs," I'd like to suggest the name "empathogenic." Empathogenic means "empathy generating." Everyone I've mentioned this name to thinks it is a good one. These drugs don't produce visions as LSD does. They don't produce multileveled thinking or objectivity toward your mind as LSD and the psychedelics do. They generate a profound state of empathy for self and other in the most general and profound terms. A state of empathy where the feeling is that the self, the other, and the world is basically good, is all right. This state can be referred to as the ground of being, the core of our being, a still point of our being. Then individuals using these substances in therapy can look at their own problems from the standpoint of stillness and empathy. They are able to do changework on themselves very rapidly, compared to ordinary therapy."
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↑"Effects of the Psychedelic Amphetamine MDA (3,4-Methylenedioxyamphetamine) in Healthy Volunteers". Journal of Psychoactive Drugs51 (2): 108–117. 2019-03-15. doi:10.1080/02791072.2019.1593560. PMID30967099.
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↑"The preclinical pharmacology of mephedrone; not just MDMA by another name". Br J Pharmacol171 (9): 2251–2268. May 2014. doi:10.1111/bph.12628. PMID24654568. "The normal routes of mephedrone administration in recreational users are reported to be oral and insufflation. Extrapolation from dosing to plasma levels is difficult as there are no detailed dose–concentration curves available and pharmacokinetic studies on the drug in humans have yet to be performed. However, it is suggested that a ‘normal’ recreational oral dose is 100–200 mg, while somewhat lower doses are used when the drug is insufflated (EROWID, 2013). This oral dose is similar to the usual oral MDMA dose typically resulting from ingestion of two tablets (140–180 mg), but an important difference with mephedrone is that the reported short duration of the psychoactive response often leads to rapid repeat dosing (Schifano et al., 2012).".
↑"Clinical Pharmacology of the Synthetic Cathinone Mephedrone". Curr Top Behav Neurosci32: 313–331. 2017. doi:10.1007/7854_2016_61. PMID28012094. "Mephedrone oral dosage ranges from 15 to 300 mg, whereas nasal insufflation dosage is somewhat lower and ranges from 5 to 200 mg. Intravenous/intramuscular injection has been reported at approximately half or one-third of oral dosage, whilst 100 mg is described as a usual rectal dose [26, 38]. The initial impact is felt by recreational users approximately 30 min after oral ingestion, with effects lasting for 2–5 h [39]; in contrast, intravenous and rectal administration produce earlier onset of action and shorter duration [40].".
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↑ 56.056.1Barceloux, Donald G., ed (9 March 2012). "Psychoactive Phenethylamine, Piperazine, and Pyrrolidinophenone Derivatives". Medical Toxicology of Drug Abuse: Synthesized Chemicals and Psychoactive Plants. Wiley. pp. 156–192. doi:10.1002/9781118105955.ch10. ISBN978-0-471-72760-6. "DOSE EFFECT: Anecdotal data suggests that recreational doses of 2C-B range from 4—30 mg with lower doses (4—10 mg) producing entactogenic effects, whereas high doses (10— 20 mg) cause psychedelic and sympathomimetic effects."
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↑ 96.096.196.2Matthew Baggott, "Advantageous benzofuran compositions for mental disorders or enhancement", US patent 20230150963, published 2023 May 18, assigned to Tactogen
↑ 98.098.1"MDMA-like stimulus effects of alpha-ethyltryptamine and the alpha-ethyl homolog of DOM". Pharmacol Biochem Behav46 (2): 459–462. October 1993. doi:10.1016/0091-3057(93)90379-8. PMID7903460.
↑"Stereoselective aspects of hallucinogenic drug action and drug discrimination studies of entactogens". Purdue University. May 1989. https://bitnest.netfirms.com/external/Theses/Oberlender1989. "The results of initial studies (Nichols et al., 1986) generally demonstrated the lack of LSD-Iike discriminative stimulus properties for the members of the entactogen drug class. This was confirmed and extended to other hallucinogens in tests with rats trained on entactogens. These results are summarized in Table 12. Table 12. Results of DD tests comparing entactogens and hallucinogens. [...] It seems clear that entactogen activity is distinct from that of hallucinogens. [...]"
↑"25X-NBOMe compounds - chemistry, pharmacology and toxicology. A comprehensive review". Crit Rev Toxicol53 (1): 15–33. January 2023. doi:10.1080/10408444.2023.2194907. PMID37115704. "For a better understanding of the actions of different NBOMes resulting from their molecular structure and receptor binding affinity, drug discrimination studies were performed. Animals trained with 4-methyl-2,5-dimethoxyamphetamine (DOM) and 3,4-methylenedioxymethamphetamine (MDMA) were used in the drug discrimination paradigm. 25B- and 25CNBOMe completely (80%) substituted DOM, while 25INBOMe produced 74% drug-appropriate responding (Gatch et al. 2017). On the other hand, only 25B-NBOMe fully substituted for MDMA, suggesting that this compound could be used as both a hallucinogen and an entactogen.".
↑"NBOMes-Highly Potent and Toxic Alternatives of LSD". Front Neurosci14: 78. 2020. doi:10.3389/fnins.2020.00078. PMID32174803. "Gatch et al. (2017) tested 25B-NBOMe, 25C-NBOMe, and 25I-NBOMe for discriminative stimulus effects similar to a prototypical psychedelic/hallucinogen DOM and to an empathogen, 3,4-methylenedioxymethamphetamine (MDMA). In DOM-trained rats 25B-NBOMe and 25C-NBOMe, but not 25I-NBOMe, fully substituted for this drug. 25B-NBOMe also fully substituted for MDMA. In both tests, the dose-effect curves for 25B-NBOMe had an inverted U-shape. It is suggested that 25B-NBOMe and 25C-NBOMe are most likely used as recreational psychedelics, although 25B-NBOMe may also be used as an empathogenic compound (Gatch et al., 2017). However, the latter assumption should be taken with caution, as some compounds (e.g., fenfluramine) that substitute for MDMA in rats do not produce MDMA-like empathogenic effects in humans (Schechter, 1988).".
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