MDMA (ecstasy) enhances emotional empathy and prosocial behavior in men but impairs recognition of negative emotions like fear, anger, and sadness, especially in women. In a placebo-controlled, double-blind crossover trial with 32 healthy volunteers, MDMA increased explicit and implicit emotional empathy on the Multifaceted Empathy Test and boosted prosocial choices on the Social Value Orientation test in men. It did not affect cognitive empathy but worsened identification of negative facial expressions on the Face Emotion Recognition Task, particularly in women. MDMA also raised plasma cortisol, prolactin, and oxytocin levels, markers linked to social behavior. These effects may explain MDMA's recreational sociability and its potential therapeutic use in psychotherapy for social dysfunction or PTSD.
Gamma-hydroxybutyrate (GHB), a GHB-/GABAB-receptor agonist, produces euphoric, disinhibiting, and vitality-enhancing effects in healthy men. In a randomized, placebo-controlled crossover trial with 16 males, a single 20 mg/kg dose increased charitable donations and prosocial money distributions among participants who initially showed low prosociality. However, GHB did not alter emotion recognition, empathy, theory-of-mind, or basic cognitive functions. The drug raised plasma progesterone levels but left oxytocin, testosterone, cortisol, aldosterone, DHEA, and ACTH unchanged. These findings suggest that GHB's mood and prosocial effects may involve GHB-/GABAB-receptors and progesterone rather than typical social hormones like oxytocin or testosterone.