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The mechanisms are fundamentally different, producing effects at different scales

USA 90 , 88568860 (1993)

Additionally, MDMA-induced changes in body temperature as well as monoamines (5HT and NE) were measured

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It acts on three key hormone pathways: GLP-1 (glucagon-like peptide-1), GIP (glucose-dependent insulinotropic polypeptide), and glucagon receptors