Oxytocin, cortisol and 3,4-methylenedioxymethamphetamine: neurohormonal aspects of recreational ‘ecstasy’

MDMA (ecstasy) affects mood and energy partly by increasing the neurohormones oxytocin and cortisol. While initial evidence linked oxytocin to enhanced sociability, that finding has not been replicated. Cortisol may amplify positive feelings from oxytocin. Chronic regular use of MDMA disrupts cortisol regulation, as shown by elevated cortisol in hair samples, altered cortisol awakening response, and higher daily stress, indicating changes to the hypothalamic–pituitary–adrenal axis. The effects of chronic use on oxytocin remain unknown. The neurohormones oxytocin and cortisol contribute to the psychobiological effects of recreational ecstasy/MDMA.

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Abstract

Most research into 3,4-methylenedioxymethamphetamine (MDMA) has debated its psychobiological effects in relation to neurotransmission. This article debates the contributory roles of the neurohormones oxytocin and cortisol for their psychobiological effects in humans. The empirical literature on these neurohormones is reviewed and suggestions for future research outlined. Acute MDMA or ‘ecstasy’ can generate increased levels of oxytocin and cortisol, and these neurohormonal changes may be important for its mood-enhancing and energy-activation effects in humans. However, an initial finding of enhanced sociability correlating with oxytocin levels has not been replicated. Potential reasons are debated. There may be dynamic interactions between the two neurohormones, with greater activation under cortisol, facilitating stronger positive feelings under oxytocin. Chronic regular use of MDMA can adversely affect cortisol in several ways. Regular users show increased cortisol in 3-month hair samples, changes to the cortisol awakening response, and indications of greater daily stress. Furthermore, these cortisol findings suggest changes to the hypothalamic–pituitary–adrenal axis. The effects of chronic MDMA usage on oxytocin still need to be investigated. It is concluded that the neurohormones oxytocin and cortisol contribute in various ways to the psychobiological effects of recreational ecstasy/MDMA.