In March, the Food and Drug Administration approved esketamine, a drug that produces psychedelic effects, to treat depression—the first psychedelic ever to clear that bar. Meanwhile the FDA has granted “breakthrough therapy” status—a designation that enables fast-tracked research—to study MDMA (also called “ecstasy”) as a treatment for post-traumatic stress disorder and psilocybin as a treatment for major depression.

While these and other psychedelic drugs show promise as treatments for specific illnesses, FDA approval means doctors could also prescribe them for other, “off-label” purposes—including enhancing the quality of life of people who do not suffer from any disorder. Hence if MDMA gains approval as a treatment for PTSD, psychiatrists could prescribe the drug for very different purposes. Indeed, before the federal government banned MDMA, therapists reported striking success in using MDMA to improve the quality of intimate relationships. Recent research bolsters these claims, finding that the drug enhances emotional empathy, increases feelings of closeness, and promotes thoughtfulness and contemplativeness.‌