MDMA acts as a potent serotonin, norepinephrine, and dopamine releaser, causing significant neurotransmitter modulation that may interrupt the hypothalamic-trigeminal neurovascular pathway implicated in cluster headache pathogenesis. Its empathogenic and entactogenic properties, mediated through serotonin 5-HT2A receptor activation and monoamine release, can potentially disrupt the neurological cascade responsible for cluster headache onset and progression. The compound's ability to induce neuroplasticity and modulate pain perception may contribute to its reported therapeutic effects in treating this severe neurological condition.