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**R-MDMA** is the R-enantiomer of 3,4-methylenedioxy-N-methylamphetamine (MDMA), also known as midomafetamine or levo-MDMA. It is a chiral small molecule and one of two enantiomers found in racemic MDMA ("ecstasy"). Like MDMA, R-MDMA acts as an entactogen/empathogen but differs pharmacologically from its S-enantiomer. It functions primarily as a serotonin–norepinephrine releasing agent and weak serotonin 5-HT2A receptor agonist with little to no significant dopamine-releasing activity. Preclinical studies suggest that R-MDMA retains therapeutic effects such as increased prosocial behavior but has reduced psychostimulant effects and lower addictive potential compared to racemic MDMA or S-MDMA. Clinical development is ongoing for psychiatric indications including post-traumatic stress disorder (PTSD), social phobia, and pervasive developmental disorders such as autism[1].
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