MDMA induces tolerance and requires dose escalation for redosing after the acute effects wear off. It’s like benzos, heroin, or speed in that respect. At least it will stop working eventually so few people would compulsively redose every day, but I’ve seen people who did it every weekend and eventually had a very bad time. Antidepressants, on the other hand, are designed for daily use (and generally require sustained use to be effective). The dynamic where you want more so you keep increasing your dose to fight tolerance until you end up worse than you started is less of a risk.

I don’t mean to attack MDMA. I think it’s great, and a lot of people could benefit from it. But I think this is a real issue if it’s easily available outside of a therapeutic context.