Table 3.
Pharmacological interventions and reported effects on empathy.
| Intervention | Primary mechanism | Empathy component affected | Reported effect size | Evidence tier | Key references |
|---|---|---|---|---|---|
| Intranasal oxytocin | Oxytocin receptor modulation; social salience | Affective empathy (context-dependent) | d = 0.24 (95% CI: 0.02–0.46) | Tier 1 | Bakermans-Kranenburg and van IJzendoorn (2013) and Stark et al., 2023 |
| MDMA-assisted therapy | Serotonin release; social reward enhancement | Affective empathy; affiliative motivation | d ≈ 0.91 (large, context-restricted) | Tier 1 | Mitchell et al. (2021, 2023) and Rein et al. (2024) |
| Psilocybin | 5-HT2A agonism; affective processing | Emotional empathy (selective) | Moderate (secondary outcomes) | Tier 2 | Jungwirth et al. (2025) |
| SSRIs | Serotonin reuptake inhibition | Affective empathy (often reduced) | Negative or blunting effects | Tier 1–2 | Rütgen et al. (2019), Ma et al. (2021), and Christensen et al. (2022) |
Effect sizes reflect pooled or representative estimates from meta-analyses or large trials where available. The tier designation follows the author-defined synthesis framework and is intended solely for integrative interpretation, not for prescriptive guidance. SSRI = selective serotonin reuptake inhibitor.