I thought MDMA worked more on dopamine?

It has a small effect on dopamine and they think noreopinephrine as well, but the primary effects are on serotonin release.  Although this does bring up a weird contradiction.  Ectasy is supposed to make you feel very sexual.  But elevated serotonin has the exact opposite effect.  This is why SSRIs can kill the desire for love or sex.  Low serotonin levels on the other hand make a person extremely hypersexual.  So there is clearly more to the story that has not been discovered yet.  Such as maybe the serotonin is being released, but being blocked from activating serotonin receptors.

The bias people have against drugs like this are unfounded. First of all, the above poster who spoke about the damage of "recreational drugs" needs to be more precise. She mentions MDMA, LSD, and methamphetamine. Hmm, I wonder which of those is more likely to have caused brain damage and birth defects.(Hint, you need a glass pipe and probably shop at Wal Mart)

Especially given the fact that LSD was given to hundreds of patients throughout the 50's and early 60's for conditions ranging from alcoholism to autism with very promising results. The "chromosome damage" myth was false propaganda. The LD50 is unbelievably high and it is very nontoxic.

MDMA was also used extensively before being outlawed in the eighties. Mainly as a adjunct to psychotherapy to foster communication between couples. The "holes in the brain" theory about ecstasy has also been shown to be a complete fabrication. There may be a "crash" associated with overuse and the resulting serotonin overload, but as far as I know there is no convincing proof of brain damage associated with it either.

I heard a lecture by a doctor recently who gave it to PTSD sufferers in a rare government approved study, and brain function was monitored very closely. Even with repeated use there was no indication of damage. In fact CNN had a recent story about brain improvements seen in treated patients. I'm not a physiologist so I can't recall the brain centers affected, but there was improved connection between parts that control the sense of self and those that control social connections and behavior.

The mechanism here must be something more complex than merely a serotonin rush. The people in these studies are cancer patients and returning war veterans with PTSD who failed to respond to SSRI's. The experience allows them to reintegrate and process the trauma in a fearless and open state of mind.

In some of these studies people have had total remission of crippling symptoms from just 1 or 2 MDMA sessions, and following up with them showed lasting changes a year or two afterwards. I think this is a promising area for research. In fact it was already promising many years ago before knee-jerk fears about kids getting high and dancing at clubs curtailed all inquiry. You wouldn't want to take the pills and dance for hours without hydrating, but done under clinical conditions it is very safe.