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When the full-sized doses (4-8 tabs) are around 500 mg, effects duplicate those seen with the microdose (4-8 tabs). They are also typically more pronounced and prolonged (e.g., 5-30 hours versus 1-2 hours). Most users describe MDMA-like effects of an introspective and panoramic nature, followed by ego dissolution, dissociation, and a series of pleasant, arousing, and sometimes painful withdrawal symptoms. Users typically report a positive and vivid experience that can endure for hours. Some of the more potent synthetic stimulants might also cause euphoria, but while MDMA can lead to a clearly defined peak experience, synthetic stimulants tend to produce a chaotic psychotic-like peak experience rather than a selective experience. At time of peak effects, experiences can be characterized by an uncanny sense of awareness, empathy, and the capability to experience something from the first-person perspective. The long-lasting EuD effects extend up to two to four weeks after the peak experience itself. In contrast to MDMA, synthetic stimulants often cause decreased anxiety and negative mood and increased happiness (1233). One can become addicted to MDMA but monotone depression, rage, or apathy are not part of that.
Limited data on MDMA use in therapy include a few small open-label studies. MDMA seems to be safe and efficacious in the treatment of posttraumatic stress, particularly in the long term (1234). MDMA labeled "on demand" also relieved anxiety to a significant degree (1235). MDMA is also being researched in the treatment of substance use disorders and anorexia. One study of MDMA treatment in obese participants resulted in comparable weight loss and mood improvement compared to regular (every-other-day or twice-a-week) psychotherapy (1236). d2c66b5586