If a pill could ease your heartbreak or enhance your relationship, would you take it?

*Originally published on April 14, 2021.

When my partner broke my heart six years ago, there was no heartache cure to save me. I couldn't pop a pill to ease my tears or lessen my cravings for the love I'd lost. 

But according to bioethicist Brian D. Earp, future generations of ex-lovers may have a faster track to recovery.

While a heartbreak pill may not turn up in our pharmacies any time soon, Earp argues that chemicals are already intruding into our romantic lives — for better or worse. He co-authored a book on the subject titled Love Drugs: The Chemical Future of Relationships.

"Love potions and magical concoctions that are supposed to affect our love lives have been consigned to literature for most of human history," said Earp, who is a research fellow at the Oxford Uehiro Centre for Practical Ethics at the University of Oxford and associate director of the Yale-Hastings Program in Ethics and Health Policy.

"But in recent years, we're beginning to learn enough about what's going on in our brains when we fall in and out of love and form attachments and so forth that it's becoming technologically feasible to intervene in those processes and have something like real-life love drugs."

Mapping love in the brain

Since functional magnetic resonance imaging (fMRI) technology first made it possible to map the brain in the early 1990s, scientists have been peeling back the curtain on the neuroscience of romance.

By the early 2000s, fMRI studies that scanned the brain activity of people deep in the throes of passion and heartbreak were giving us a glimpse into the chemical underpinnings of love.

And as researchers continue to study the key brain circuits and hormones at play when we fall in and out of love, new ways of manipulating those processes are beginning to emerge.

"We don't have a choice to remain in the dark about it any more," Earp said.

In 2010, researchers at the University of Kentucky found that the simple act of popping acetaminophen could reduce the physical symptoms of social rejection, suggesting that even basic painkillers could be used to assuage heartbreak.

Earp isn't necessarily encouraging people to medicate to get over their broken hearts. But he says pain relievers are not the only drugs in our medicine cabinet that have the potential to affect our emotions and sex drive.

Blood pressure pills, morphine, hydrocodone and statin cholesterol drugs can all inadvertently dampen our libido, for example.

Other common medications, such as SSRIs, used to treat depression and obsessive-compulsive disorder (OCD), can indirectly influence human relationships. 

On some occasions, antidepressants might enhance a relationship by improving a romantic partner's emotional well-being; in other cases, they could interfere in a couple's sex life by causing impotence or reducing attraction.

In one 1997 case study, published in the Australian and New Zealand Journal of Psychiatry, a man overcame his extreme jealousy within his marriage after being treated with a common medication for OCD. 

According to the researchers, the man's jealous habits — which included "obsessional thinking patterns and compulsive behaviours" — bore the hallmarks of OCD and were eased when he was treated for it.

Chemical cure for heartbreak has limits

Writer Kayt Sukel, author of Dirty Minds: How Our Brains Influence Love, Sex and Relationships, says that outside the confines of a lab, it's unlikely that any chemical intervention could have a predictable impact on love.

"Even if we could come up with a formula that might work, it ignores the realities of the fact that our brain is always changing, our brain is neuroplastic," Sukel said.

"And so when I think about the hard work of a relationship, [there] are all those factors that could undo that careful formulation in a billion different, unexpected ways."

Earp acknowledges that those suffering from a broken heart or an emotionally distant partner should not expect a chemical cure from so-called love drugs. 

"They don't work exactly like love potions," he said. "They're not magical. They have limitations. They're blunt. They're messy."

Still, he argues the rise of pharmaceutical interventions in our relationships should not be dismissed.

"All of our drugs are blunt, but they're not random, and they're not totally outside of our control." 

While modulating love with drugs might sound novel, Earp argues that, knowingly or not, many of us are already using chemicals in our relationships. For starters, there's the bottle of wine or other types of alcohol that help reduce first date jitters or give someone the liquid courage to approach a love interest.

"These love drugs that we're talking about are in some sense continuous with chemical interventions we're already familiar with," he said.

"There are medications that we currently use for other purposes that affect our romantic attachments. And there's also drugs that are coming around on the horizon that are likely to be much more powerful.

MDMA studies underway

One such drug is already being studied in this context in Canada.

Toronto-based psychologist and clinical researcher Anne Wagner is studying the use of MDMA, commonly known as ecstasy or molly, in couples counseling for patients with PTSD.

In a 2016 non-controlled pilot study, Wagner's team recruited six PTSD patients and their romantic partners to participate in 12 intensive psychotherapy sessions. During two of those sessions, the partners took MDMA together.

Wagner, who has been providing couples counselling since 2009, says PTSD can lead some people to avoid difficult feelings or scenarios, which can have a profound impact on romantic partnerships.

Preliminary findings from Wagner's research, which did not compare the six couples against a control group, suggest MDMA can help couples work through trauma, in part by affecting hormones such as oxytocin that may help facilitate interpersonal trust and attachment.

"When people are taking it in the course of therapy, it's helping folks come to a place where they're able to experience their feelings, experience different thoughts and memories, for example, of the trauma that perhaps they haven't been able to be with," Wagner said.

Despite its reputation as a rave drug, Wagner says, the experience of taking MDMA in a clinical setting is not necessarily a joyful one. Nor is it a cure for relationship ills.

"It's allowing people to ... have more experiences of empathy, of connection, of some feelings of love that perhaps they've been numbed out around."

Wagner is quick to note that her results are preliminary but said that six months after the study concluded, the majority of the couples involved reported a reduction in PTSD symptoms and an increase in relationship satisfaction.

The longer-term efficacy of the therapy remains to be determined, however.

Evidence of impact needed

Steve Joordens, a professor of psychology at the University of Toronto, said that while Wagner's MDMA research sounds intriguing, further study is needed.

"The challenge right now ... is to show really clear evidence of the impact, of efficacy," Joordens said. 

He said this type of research is still in the early stages but that "it's getting serious attention."

Wagner is currently developing a large, randomized trial of MDMA-assisted psychotherapy for couples, which she hopes to run in Toronto.

She says hers is the first North American research team to study MDMA for couples since the drug was made illegal in the 1970s and 1980s, but that research on its use as a PTSD treatment is well underway.

In 2017, MDMA-assisted psychotherapy for PTSD was designated as a "breakthrough therapy" by the U.S. Food and Drug Administration, paving the way for Phase 3 trials that could see the drug approved for PTSD treatment as early as 2023.

Earp also points to psilocybin, or magic mushrooms, another psychedelic drug currently being studied as a possible treatment for PTSD and other mental disorders. 

While it is not being studied directly in the context of romantic relationships, Earp says, it as an example of the broader field of psychedelic drug research on mental illness that can have a knock-on effect on relationships.

As with MDMA-assisted therapy, early studies suggest that psilocybin may be effective in helping some people overcome difficult emotions and unhealthy patterns of thought when used in conjunction with therapy. 

"Those two drugs are now getting really careful scrutiny from scientists and regulators because … they seem like they're having pretty big effects on people's minds and lives and potentially on their relationships," Earp said.

Ethical boundaries needed to avoid misuse

Those who see heartbreak or unrequited love as also having positive effects, such as personal growth or great art, might be uncomfortable with the prospect of a pharmaceutical shortcut to recovery.

Earp and others also warn that without careful regulation, love drugs could be misused.

Carrie Jenkins, a professor of philosophy at the University of British Columbia in Vancouver, warns that if love drugs are used to uphold harmful societal norms, they could threaten romance itself.

Jenkins points to harmful practices such as conversion therapy for LGBTQ people as a cautionary example of how social groups have historically policed attraction — and might try to use new technologies in the future.

"We have a history with … trying to use literal medical forms of intervention to get people to have these romantic relationships with the right kind of other person and maintain the status quo," she said.

Jenkins, who is polyamorous, used to feel guilty when she experienced romantic feelings that didn't line up with societal expectations of monogamy.

"Under those pressures, I might quite well have been inclined to take a drug that would help me to stop falling in love with too many more people," she said.

"However, now that I understand what polyamory is ... I'd much rather do that than take the pill so that I can conform to somebody else's ideas about what love should look like."

For Earp, these risks underscore the urgent need for an ethical framework around the use of love drugs — starting with the establishment of basic ground rules, such as consent.

"The idea that you might, for example … introduce a drug without someone's knowledge or awareness or full understanding or consent — that's the brightest red line that we draw throughout the book."

Still, Earp says it's only a matter of time until we start to see more targeted pharmaceutical interventions.

"We need to get ahead of this technological development and have an ethical conversation in society about what we want to do with the prospect of manipulating our own romantic neurochemistry and toward what ends."

About the author

Annie Bender is a CBC Radio producer with Day 6 and Ideas. Her radio documentary Love on Drugs was inspired by an unusual breakup experience that left her thinking differently about the chemical side of love.

Guests in the Ideas episode Love on Drugs:

Brian D. Earp research fellow at the Oxford Uehiro Centre for Practical Ethics at the University of Oxford and associate director of the Yale-Hastings Program in Ethics and Health Policy; co-author of Love Drugs: The Chemical Future of Relationships.

Carrie Jenkins is a Canada Research Chair and professor of Philosophy at the University of British Columbia and author of What Love Is And What It Could Be.

Dr. Anne Wagner is a Toronto-based clinical psychologist and researcher studying MDMA-assisted conjoint therapy for PTSD. She's also the founder of Remedy Centre.