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Serotonin–norepinephrine releasing agent · Serotonin 5-HT2A receptor agonist · Entactogen · Empathogen

(R)-MDMA

Also called (-)-Methylenedioxymethamphetamine

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Part of the metabolic pathway of (R)-MDMA. See the timeline on the metabolic highway.

Enzymes that break it down: CYP2D6. Wikipedia’s drug infobox says: “CYP2D6” (revision 1370020651).

Overview

(R)-3,4-Methylenedioxy-N-methylamphetamine ([R]-MDMA), also known as (R)-midomafetamine or as levo-MDMA, is the (R)- or levorotatory (l-) enantiomer of 3,4-methylenedioxy-N-methylamphetamine (MDMA; midomafetamine; "ecstasy"), a racemic mixture of (R)-MDMA and (S)-MDMA. Like MDMA, (R)-MDMA is an entactogen or empathogen. It is taken by mouth.[1][2] WP

The drug is a serotonin–norepinephrine releasing agent (SNRA) and weak serotonin 5-HT2A receptor agonist. It has substantially less or no significant dopamine-releasing activity compared to MDMA and (S)-MDMA. In preclinial studies, (R)-MDMA shows equivalent therapeutic-like effects to MDMA, such as increased prosocial behavior, but shows reduced psychostimulant-like effects, addictive potential, and serotonergic neurotoxicity. In clinical studies, (R)-MDMA produces similar effects to MDMA and (S)-MDMA, but is less potent and has a longer duration.[1–5] WP

(R)-MDMA was first described in enantiopure form by 1978. Under the developmental code names EMP-01, developed by AtaiBeckley, and DT402 (formerly MM402), developed by Definium Therapeutics (formerly MindMed), it is under development for the treatment of post-traumatic stress disorder (PTSD), social phobia, and pervasive development disorders (PDDs) such as autism. It is thought that (R)-MDMA might have a better safety profile than MDMA itself whilst retaining its therapeutic benefits.[1][6–11] WP

Drug class

Serotonin–norepinephrine releasing agent Serotonin 5-HT2A receptor agonist Entactogen Empathogen WP

From the Wikipedia article's infobox.

Uses, dosage and effects

Use and effects

(R)-MDMA has a dose of 125 to 300 mg orally and a duration of 3.5 to 5.2 hours. It has been estimated that doses of 125 mg MDMA, 100 mg (S)-MDMA, and 300 mg (R)-MDMA are equivalent.[2] WP

The first modern clinical study of the comparative effects of MDMA, (R)-MDMA, and (S)-MDMA was published in August 2024. It compared 125 mg MDMA, 125 mg (S)-MDMA, 125 and 250 mg (R)-MDMA, and placebo. (R)-MDMA increased any drug effect, good drug effect, drug liking, stimulation, drug high, alteration of vision, and alteration of sense of time ratings similarly to MDMA and (S)-MDMA. However, (S)-MDMA 125 mg was more potent in increasing subjective effects, including stimulation, drug high, happy, and open, among others, than (R)-MDMA 125 or 250 mg or MDMA 125 mg. Ratings of bad drug effect and fear were minimal with MDMA, (R)-MDMA, and (S)-MDMA. In contrast to expectations, (R)-MDMA did not produce more psychedelic-like effects than (S)-MDMA. Besides subjective effects, (R)-MDMA increased heart rate, blood pressure, and body temperature similarly to MDMA and (S)-MDMA, though it was less potent in producing these effects. Body temperature was notably increased to the same extent with (R)-MDMA 250 mg as with MDMA 125 mg and (S)-MDMA 125 mg.[2][5] WP

The differences in effects between (R)-MDMA and (S)-MDMA may reflect the higher potency of (S)-MDMA rather than actual qualitative differences between the effects of (S)-MDMA and (R)-MDMA. It was estimated that equivalent effects would be expected with (S)-MDMA 100 mg, MDMA 125 mg, and (R)-MDMA 300 mg. The findings of the study were overall regarded as not supporting the hypothesis that (R)-MDMA would produce equivalent therapeutic effects as (S)-MDMA or MDMA whilst reducing safety concerns. However, more clinical studies were called for to assess the revised estimated equivalent doses of MDMA, (R)-MDMA, and (S)-MDMA.[2][5] WP

Pharmacology

Pharmacodynamics

MDMA is a well-balanced serotonin–norepinephrine–dopamine releasing agent (SNDRA). (R)-MDMA and (S)-MDMA are both SNDRAs similarly. However, (R)-MDMA is several-fold less potent than (S)-MDMA in vitro and is also less potent than (S)-MDMA in vivo in non-human primates. In addition, whereas MDMA and (S)-MDMA are well-balanced SNDRAs, (R)-MDMA is comparatively much less potent as a dopamine releasing agent (~11-fold less potent in releasing dopamine than serotonin), and could be thought of instead more as a serotonin–norepinephrine releasing agent (SNRA) than as an SNDRA. In non-human primates, (S)-MDMA demonstrated significant dopamine transporter (DAT) occupancy, whereas DAT occupancy with (R)-MDMA was undetectable. Similarly, MDMA and (S)-MDMA were found to increase dopamine levels in the striatum in rodents and non-human primates, whereas (R)-MDMA did not increase striatal dopamine levels. As such, (R)-MDMA may be less psychostimulant-like than MDMA or (S)-MDMA.[1–4][12][13][14] WP

In addition to its actions as an SNDRA, MDMA has weak affinity for the serotonin 5-HT2A, 5-HT2B, and 5-HT2C receptors, where it acts as an agonist. (R)-MDMA shows higher affinity for the serotonin 5-HT2A receptor than (S)-MDMA or MDMA. In addition, (R)-MDMA is more potent as an agonist of the serotonin 5-HT2A receptor, acting as a weak partial agonist of this receptor, whereas (S)-MDMA shows very little effect. Conversely however, (S)-MDMA is more potent as an agonist of the serotonin 5-HT2C receptor. Based on these findings, it has been hypothesized that (R)-MDMA may be more psychedelic-like than (S)-MDMA. However, although (R)-MDMA partially substitutes for lysergic acid diethylamide (LSD) in animal drug discrimination tests, it did not produce the head-twitch response, a behavioral proxy of psychedelic effects, at any tested dose. In any case, findings in this area are conflicting. (R)-MDMA is inactive as an agonist of the human TAAR1, whereas (S)-MDMA shows very weak potency as an agonist of the receptor (EC₅₀ (half-maximal effective concentration) = 74,000 nM).[1][2][15–18] WP

MDMA is a well-known serotonergic neurotoxin and this has been demonstrated both in animals and in humans. There is evidence that the serotonergic neurotoxicity of MDMA may be driven primarily by (S)-MDMA rather than (R)-MDMA. (R)-MDMA shows substantially lower or potentially no neurotoxicity compared to (S)-MDMA in animal studies. This has been the case even when doses of (R)-MDMA were increased to account for its lower potency than (S)-MDMA. However, more research is needed to confirm this in other species, such as non-human primates. In contrast to (S)-MDMA, (R)-MDMA does not produce hyperthermia in rodents, and this may be involved in its reduced risk of neurotoxicity, as hyperthermia augments and is essential for the serotonergic neurotoxicity of MDMA. The reduced potency of (R)-MDMA as a dopamine releasing agent may also be involved in its reduced neurotoxic potential, as dopamine release is likewise essential for the neurotoxicity of MDMA. The hyperthermia of MDMA may in fact be mediated by dopamine release. As (R)-MDMA is less neurotoxic than (S)-MDMA and MDMA or even non-neurotoxic, it may allow for greater clinical viability and prolonged regimens of drug-assisted psychotherapy.[1][4] WP

(R)-MDMA and (S)-MDMA have shown equivalent effects in terms of inducing prosocial behavior in monkeys. However, (S)-MDMA shows higher potency, whereas (R)-MDMA shows greater maximal effects. Conversely, (S)-MDMA does not increase prosocial behavior in mice, whereas both MDMA and (R)-MDMA do so. MDMA and (S)-MDMA increase locomotor activity, a measure of psychostimulant-like effect, in rodents, whereas (R)-MDMA does not do so. (R)-MDMA likewise showed fewer reinforcing effects than (S)-MDMA in non-human primates. These findings further add to (R)-MDMA showing reduced psychostimulant-like and addictive effects compared to MDMA and (S)-MDMA.[1][4] WP⚠ A table follows this text in the source and is not copied here. Open the source to see it.

Pharmacokinetics

The elimination half-life of (S)-MDMA is 4.1 hours, whereas the half-life of (R)-MDMA is 12 to 14 hours. In the case of racemic MDMA administration, the half-life of (S)-MDMA is 5.1 hours and the half-life of (R)-MDMA is 11 hours. (R)-MDMA shows cytochrome P450 CYP2D6 inhibition and lower levels of the metabolite 4-hydroxy-3-methoxymethamphetamine (HMMA) than (S)-MDMA.[2][5] WP

Research

Research

(R)-MDMA is under development separately by AtaiBeckley, Empath Biosciences (EmpathBio) and Definium Therapeutics (formerly MindMed). It is being developed by AtaiBeckley for social anxiety disorder, by Empath Biosciences for the treatment of PTSD and social phobia and it is being developed by Definium Therapeutics for the treatment of PDDs or autism. As of February 2026, the drug is in phase 2 clinical trials for social phobia and autistic spectrum disorders, whereas no recent development has been reported for PTSD. The results of AtaiBeckley's phase 2a trial for treatment of social phobia have been released, with the drug showing moderate effectiveness and a generally favorable safety profile for this indication.[9][10][11][19][20] WP

History

History

(R)-MDMA was first described in the scientific literature in enantiopure form by 1978. It was described in a paper authored by Alexander Shulgin, David E. Nichols, and other colleagues.[6] WP

Chemistry

Formula
C11H15NO2 PC
CAS number
81262-70-6 PC
Molar mass (g/mol)
193.24 PC
IUPAC name (computed by PubChem)
(2R)-1-(1,3-benzodioxol-5-yl)-N-methylpropan-2-amine PC
SMILES
C[C@H](CC1=CC2=C(C=C1)OCO2)NC PC
InChIKey
SHXWCVYOXRDMCX-MRVPVSSYSA-N PC
PubChem CID
667458
IUPAC name
(2R)-1-(1,3-benzodioxol-5-yl)-N-methylpropan-2-amine WP

Harm reduction information

No harm reduction data is on file for this compound yet. That means no dose, timing or combination data from PsychonautWiki or TripSit. Please don't guess a dose from similar compounds. If you have taken it and feel unwell, contact emergency services or a poison control center.

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Sources

  1. Journal / agency Pitts EG, Curry DW, Hampshire KN, Young MB, Howell LL. (±)-MDMA and its enantiomers: potential therapeutic advantages of R(−)-MDMA. Psychopharmacology. February 2018. doi:10.1007/s00213-017-4812-5 · PMID 29248945
  2. Journal / agency Straumann I, Avedisian I, Klaiber A, Varghese N, Eckert A, Rudin D, Luethi D, Liechti ME. Acute effects of R-MDMA, S-MDMA, and racemic MDMA in a randomized double-blind cross-over trial in healthy participants. Neuropsychopharmacology. August 2024. doi:10.1038/s41386-024-01972-6 · PMID 39179638 · PMC11631982
  3. Journal / agency Rothman RB, Baumann MH. Therapeutic potential of monoamine transporter substrates. Current Topics in Medicinal Chemistry. 2006. doi:10.2174/156802606778249766 · PMID 17017961
  4. Journal / agency Curry DW, Young MB, Tran AN, Daoud GE, Howell LL. Separating the agony from ecstasy: R(−)-3,4-methylenedioxymethamphetamine has prosocial and therapeutic-like effects without signs of neurotoxicity in mice. Neuropharmacology. January 2018. doi:10.1016/j.neuropharm.2017.10.003 · PMID 28993129 · PMC5714650
  5. Journal / agency Bedi G. Is the stereoisomer R-MDMA a safer version of MDMA?. Neuropsychopharmacology. October 2024. doi:10.1038/s41386-024-02009-8 · PMID 39448866 · PMC11631934
  6. Journal / agency Anderson GM, Braun G, Braun U, Nichols DE, Shulgin AT. Absolute configuration and psychotomimetic activity. NIDA Research Monograph. 1978. PMID 101890
  7. Other atai Life Sciences Announces Positive Topline Results from Single Ascending Dose Phase 1 Study with EMP-01 (R-MDMA)
  8. Other MM-402 by Mind Medicine MindMed for Autism Spectrum Disorder (ASD): Likelihood of Approval. 9 February 2024
  9. Journal / agency EMP 01 (R-MDMA). 20 August 2024
  10. Journal / agency R(−)-Methylenedioxymetamfetamine (MM-402; R(−)-MDMA). 30 January 2024
  11. Other Delving into the Latest Updates on EMP-01 with Synapse. 1 November 2024
  12. Journal / agency Rothman RB, Baumann MH. Monoamine transporters and psychostimulant drugs. European Journal of Pharmacology. October 2003. doi:10.1016/j.ejphar.2003.08.054 · PMID 14612135
  13. Journal / agency Setola V, Hufeisen SJ, Grande-Allen KJ, Vesely I, Glennon RA, Blough B, Rothman RB, Roth BL. 3,4-methylenedioxymethamphetamine (MDMA, "Ecstasy") induces fenfluramine-like proliferative actions on human cardiac valvular interstitial cells in vitro. Molecular Pharmacology. June 2003. doi:10.1124/mol.63.6.1223 · PMID 12761331
  14. Journal / agency Acquas E, Pisanu A, Spiga S, Plumitallo A, Zernig G, Di Chiara G. Differential effects of intravenous R,S-(+/-)-3,4-methylenedioxymethamphetamine (MDMA, Ecstasy) and its S(+)- and R(−)-enantiomers on dopamine transmission and extracellular signal regulated kinase phosphorylation (pERK) in the rat nucleus accumbens shell and core. Journal of Neurochemistry. July 2007. doi:10.1111/j.1471-4159.2007.04451.x · PMID 17564678
  15. Journal / agency Kaur H, Karabulut S, Gauld JW, Fagot SA, Holloway KN, Shaw HE, Fantegrossi WE. Balancing Therapeutic Efficacy and Safety of MDMA and Novel MDXX Analogues as Novel Treatments for Autism Spectrum Disorder. Psychedelic Medicine. 2023. doi:10.1089/psymed.2023.0023 · PMID 40046567 · PMC11661495
  16. Other Dunlap, Lee E. Development of Non-Hallucinogenic Psychoplastogens. 2022
  17. Journal / agency Halberstadt AL, Geyer MA. Behavioral Neurobiology of Psychedelic Drugs. 2018. doi:10.1007/7854_2016_466 · PMID 28224459 · PMC5787039
  18. Journal / agency Lewin AH, Miller GM, Gilmour B. Trace amine-associated receptor 1 is a stereoselective binding site for compounds in the amphetamine class. Bioorg Med Chem. December 2011. doi:10.1016/j.bmc.2011.10.007 · PMID 22037049 · PMC3236098
  19. Other Maddox, Will. Analysts see potential in MDMA drug after AtaiBeckley reports improvements in anxiety trial. 26 February 2026
  20. Other Delving into the Latest Updates on MM-402 with Synapse. 1 November 2024
  21. Other Controlled Drugs and Substances Act. 5 December 2025

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