How Long Does MDMA Last? .The effects of MDMA usually appear around 20–60 minutes after taking the dose and last up to 6 hours.

The duration of effects depends on what other ingredients may be included in the powder or tablets you’re using. It’s exceedingly rare to find ecstasy tablets that contain pure MDMA these days. Some ecstasy tablets can last up to 10 hours; others have a much shorter duration.

What is MDMA-Assisted Psychotherapy?

Psychedelic-assisted psychotherapy is the practice of using psychedelic substances (including MDMA) to treat specific mental health disorders. 

MDMA-assisted psychotherapy was a common practice in the 70s and 80s but was banned for the past four decades. Only recently has this practice started to pick up where it left off thanks to the efforts of MAPS (the Multidisciplinary Association for Psychedelic Studies) and their research on the therapeutic role of MDMA for various medical disorders.

Today, MDMA is still considered a Schedule I drug in the United States — which implies the drug is highly addictive and has no medical value. Despite this, there’s been a big push to bring MDMA back into the medical system through an Expanded Access Program.

The focal point of MDMA-assisted therapy at the moment revolves around the use of the substance for PTSD. This comes after a statement from the FDA that MDMA is a potential “breakthrough therapy” for treating PTSD. MAPS then set out to conduct a new phase 3 clinical research program to further legitimize the use of MDMA for this application.

Most of the clinics currently awaiting approval for the expanded access program aim to use the MDMA for the treatment of patients diagnosed with PTSD.

There are plenty of other medical applications of MDMA, however — with research supporting the use of MDMA for eating disorders, addiction, alcohol abuse disorder, existential depression, and more.

MDMA-assisted psychotherapy for PTSD is expected to cost around $15,000 — which is about the average cost of conventional PTSD treatment over the course of several years.

1. MDMA For Post Traumatic Stress Disorder (PTSD)

PTSD is a chronic mental health disorder that develops after a traumatic event. It can involve recurrent memories, nightmares, flashbacks, anxiety attacks, or a sense of impending doom.

Patients with PTSD often experience insomnia, anxiety, addiction, depression, irritability, or self-destructive behaviors alongside the condition.

The condition is very common — affecting roughly 8 million Americans every year.

MDMA is the most promising therapeutic option currently being explored in the treatment of PTSD. 

A pilot study funded by MAPS explored the effects of MDMA-assisted therapy with 20 PTSD sufferers [2]. Twelve patients were given MDMA, and eight were given a placebo. All patients taking part in this trial failed to respond to other therapies.

Of the 12 patients given MDMA and psychotherapy integration, 83% reported significant improvements in their condition. In the follow-up period after the trial, 83% of the patients that took MDMA no longer met the criteria for PTSD diagnosis. A three-year follow-up study reported that 74% of patients in the treatment group remained free from PTSD [4].

The outcome of this study was remarkable and prompted an immediate focus on the effects of MDMA for PTSD. Current medical treatments for the condition are insufficient. The most common prescriptions for PTSD are benzodiazepine drugs like Xanax, Ativan, or Valium.

A recent meta-analysis reviewed 18 studies on the use of benzodiazepines for PTSD (including over 5200 patients) found no evidence to suggest these medications are effective for treating PTSD [3]. In fact, there was even evidence to suggest it might make symptoms worse.

We’re in dire need of effective treatment protocols for this condition.

This is one of the main drivers for the development of the expanded access program that allows patients and practitioners access to MDMA for the treatment of PTSD and related mental health disorders.

MAPS is currently performing a phase III clinical trial exploring the effects of MDMA for post-traumatic stress disorder.

Make sure to subscribe to our newsletter to stay up to date on the developments in the psychedelic space as the results of this research become available.

Suggested Reading: Can Psychedelics Heal Trauma?

2. MDMA For Social Anxiety Disorder In Autistic Adults

A double-blind, placebo-controlled pilot study found a rapid improvement in symptoms of social anxiety in autistic adults [1]. Experimental sessions were spaced one month apart and consisted of 2 8-hour treatment sessions (either 75-125 mg MDMA or placebo) — followed by three non-drug psychotherapy follow-up or integration sessions.

This study used the Liebowitz Social Anxiety Scale (LSAS) to measure the severity of anxiety before the trial and after each session. Scores were recorded again six months after the conclusion of the last experimental session.

The results of this study have been extremely positive — prompting much larger studies.

MAPS is currently raising funding to conduct a new study exploring the effects of MDMA-assisted therapy as a potential treatment for social anxiety disorder in autistic individuals. Currently, there are no effective treatments for managing social anxiety in this population.

3. MDMA-Assisted Couples Therapy

MDMA isn’t used in couples therapy at the moment — not in the United States at least. However, it was once considered invaluable for repairing disconnected or damaged relationships.

MDMA (or other chemical interventions) were especially useful for what we could call “gray” marriages — relationships that aren’t hateful or abusive, just unsatisfying. This can happen for a number of reasons — such as stagnation or dramatic differences in sex drive.

Therapists would administer MDMA to both parties. The couple would lay on a comfortable couch with eyeshades on and start talking whenever they were ready [11]. Sessions can last for several hours, and the therapist acted as both a catalyst and a mediator for the conversation. It was very common for there to be significant emotional breakthroughs after just a single session with MDMA.

MDMA works by decreasing irrational fear responses to perceived emotional threats.

What this means in basic terms is that it removes barriers that may be preventing couples from connecting and opening up to each other emotionally.

Emotional repression is one of the leading causes of relationship issues.

Using chemicals like MDMA to dissolve these repressive emotions is often enough to bring the couple back into harmony with each other.

There’s been a push towards bringing MDMA back into couples therapy along with the renewed interest in this chemical for its applications in other psychotherapies. MAPS is planning an upcoming clinical trial to explore the effects of MDMA-assisted therapy for post-traumatic stress disorder in couples.

As laws change and more research enters the public domain, we expect to see MDMA therapy become more readily available in the United States, Canada, and Europe once again.

Also see: MDMA for Women’s Low Libido (HSDD).

What Does Expanded Access for MDMA Mean?

Currently, MDMA is only officially legal for use inside approved laboratories. It’s only permitted for research purposes — not therapeutic use.

The expanded access program (part of the “Compassionate Use Act”) gives access to the substance outside the lab. It’s designed to help licensed medical practitioners and clinics begin administering MDMA and other psychedelic substances to their patients with certain medical conditions.

MAPS recently submitted a protocol to the FDA to allow clinics to apply and undergo specific training on how to integrate MDMA into their practice. The training is projected to cost around $9,000 and provides accreditation for mental health clinics to begin using MDMA — pending approval by the FDA.

The first MDMA clinic is projected to open later this year in Oregon. The clinic — Somatic Center Portland will offer MDMA-assisted psychotherapy specifically for people suffering from PTSD.

How Strong is MDMA Compared To Other Psychedelics?

MDMA is technically classified as a psychedelic because it targets many of the same receptors used by conventional psychedelics like LSD, psilocybin, and DMT. Classical psychedelics focus on the 5-HT2C receptor, which is the main mechanism of action involved in producing visual and auditory hallucinations.

MDMA is a little bit different in that it focuses on the 5-HT2B receptor instead. This receptor isn’t strongly associated with changes in visual or auditory perception but has a strong impact on our feeling of connectedness, empathy, and emotion.

Overall, the effects of MDMA are much more stimulating than most psychedelics. It’s most similar to compounds like 2C-B or low-dose ketamine.

MDMA vs. 2C-B

2C-B is often described as a blend of MDMA and LSD in terms of its effects. While this is a good summary, the experience of both substances is distinct from each other. The overlap comes from the empathogenic effects of both substances. This means they create a sense of openness and connectedness with others.

Low doses of 2C-B are the most similar to MDMA, but the effects differentiate at the higher doses.

MDMA remains focused on the empathogenic and stimulating effects in high doses, while 2C-B becomes much more psychedelic in nature.

Both substances are often used interchangeably at concerts, music festivals, or parties. Other related 2C-x compounds such as 2C-E and 2C-I share a similar overlap in effects with MDMA as well.


MDA (methylenedioxyamphetamine) is a close relative of MDMA. In fact, it’s one of the metabolites of MDMA that’s created by our liver as it metabolizes it into smaller pieces.

The effects of MDMA and MDA are very similar — both promote a sense of openness and connectedness, and both act as potent central nervous system stimulants.

The key differences between these two revolve around the focus of the experience.

MDMA produces much more of the “lovey” feelings, while MDA is slightly more psychoactive and stimulating. Most people who have used both substances prefer the effects of MDMA over MDA.

MDMA vs. Ketamine

The effects of ketamine are highly dependent on the dose used. Lower doses are used interchangeably with MDMA at concerts, clubs, and music festivals. It’s stimulating and promotes a sense of clarity, energy, and connection in a similar way to MDMA. The effects between these two substances are similar in that they have many of the same qualities — but they’re distinctly different from each other.

High doses of ketamine are very different. It becomes substantially more psychedelic in higher doses and can even lead to out-of-body experiences. Higher doses of ketamine are not ideal for use in loud, busy, or active environments at this dose and are completely different from the effects experienced under the influence of MDMA.

Some people choose to combine the effects of ketamine and MDMA together for a dissociated, but euphoric mind state. This practice is termed “kitty flipping.”

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