Sessa · Journal of psychopharmacology (Oxford, England) 2022 · open-label uncontrolled study · n=14

Debunking the myth of 'Blue Mondays': No evidence of affect drop after taking clinical MDMA.

Cited 18 times in the scientific literature.

Level 4 - case-series / case-control

Open-label uncontrolled study (case series / single cohort)

PubMed 34894842 · doi:10.1177/02698811211055809 · record verified 2026-08-26

What was done

An open-label study evaluated 14 participants with alcohol use disorder receiving MDMA-assisted psychotherapy. Researchers assessed mood during the week after drug administration, self-reported sleep quality at baseline and at 3- and 6-month follow-ups, illicit MDMA use or desire, and anecdotal participant feedback.

What was found

The abstract reports directional outcomes without quantitative metrics. Participants maintained a positive mood during the week following clinical MDMA administration, with no reported drop in affect. Self-reported sleep quality improved relative to baseline at 3- and 6-month follow-ups. No participants reported using or desiring illicit MDMA, and anecdotal feedback on treatment was favorable.

Why it matters

The findings suggest that post-acute mood drops ('Blue Mondays') seen with recreational ecstasy may be driven by recreational confounds rather than clinically administered MDMA.

Limits

The study is limited by an extremely small sample size (n = 14), lack of a control or placebo group, and an open-label design. The abstract provides no numerical data, confidence intervals, or statistical test values, and findings in alcohol use disorder may not generalize to other clinical populations.

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