MDMA, known as ecstasy, is a small molecule that shapes youth culture similarly to LSD in the 1960s. Structurally related to amphetamine and mescaline, it produces unique subjective effects distinct from psychostimulants or hallucinogens and reliably induces prosocial states. This review covers MDMA's synthesis, pharmacology, metabolism, adverse effects, and potential medical uses. The authors argue MDMA may be the most important compound for the future of psychedelic science, capable of either advancing new research or triggering a second Dark Age for the field.
Antidepressant use during pregnancy has limited adverse effects on fetal health and child development, particularly for SSRIs and SNRIs, while untreated maternal depression carries well-researched harms. Pregnancy alters drug disposition and metabolism, affecting both mother and fetus. The FDA advises caution due to a lack of safety studies, as pregnant individuals are often excluded from clinical trials. The review asserts that individuals should be counseled on risks and benefits of treatment, as withholding treatment has possible negative outcomes. Newer therapeutics like ketamine and κ-opioid receptor antagonists warrant further investigation for use during pregnancy.