Within the arena of mental healthcare, the winds of change are certainly apparent. In the last decade, the nation has seen a majority of states legalize the use of marijuana for medical uses. More recently, the FDA has supported increased research on the use of psilocybin or magic mushrooms for depression treatment. Now it appears the same considerations are being given to another psychedelic treatment, MDMA. Known also as Ecstasy or Molly, MDMA is another Schedule I controlled substance that had been previously banned. But researchers and pharmaceutical companies are demonstrating the benefits of MDMA-assisted therapy. And based on their findings, it could well be a treatment for PTSD in the near future.
(There are a multitude of health benefits to psilocybin use–read up on them in this Bold story.)
PTSD, or post-traumatic stress disorder, is both common as well as difficult to treat. Existing therapies help some people suffering from this condition, but the statistics are far from ideal. As such, treating PTSD with psychedelics like MDMA is being explored as a better alternative. As it turns out, MDMA-assisted therapy for this condition has shown significant promise. There are societal and legal battles to be had as well as those related to costs. But if research continues to prove the advantages of treating PTSD with psychedelics, the barriers will be easier to overcome. This would make MDMA the third psychedelic trying to breakthrough into the medical and mental health arena. It’s just another example of how a notable shift in how psychedelics are being perceived today.
“The big tragedy to point out is that it was pretty clear in the late 1970s and early 1980s that MDMA had incredible therapeutic potential. All the suffering since then, because MDMA was criminalized, is enormous.” – Rick Doblin, Founder of the Multidisciplinary Association for Psychedelic Studies (MAPS)
The Potential for MDMA in PTSD
Like other hallucinogens and psychedelics, MDMA has been around since the 1960s. And like other similar compounds, it was actually developed initially as a therapeutic compound. It was used in the U.S. and Europe as a talk therapy adjunct to help trauma victims. But in 1986, as part of the War on Drugs, it became categorized as a Schedule I drug. This implied it had no known medical benefits, making it illegal to consumer and possess. Prior to this, many believed in its mental health benefits, particularly those involving PTSD and anxiety. And despite its illegality, research groups continued to advocate for its therapeutic uses. Things finally shifted in 2017 when the FDA re-labelled MDMA as a potential breakthrough therapy for PTSD. This allowed companies to “fast-track” research regarding MDMA-assisted therapy as a result.
Officially named 3,4-Methylenedioxymethamphetamine, MDMA works at the level of neurons within the brain. In essence, it increases concentrations of several brain neurotransmitters including serotonin, norepinephrine, and dopamine. But unlike other medications, it has more lasting effects, especially on serotonin systems. As such, it reduces the degree of anxiety associated with past traumas, which allows more in-depth therapy to occur. This is why researchers believe treating PTSD with psychedelics like MDMA have potential. By reducing the emotional and psychological effects triggered by past traumas, MDMA-assisted therapy allows other therapies to work better. Negative memories are less frightening, which permits more extended sessions and better outcomes.
“MDMA-assisted therapy would be the first novel treatment for PTSD in over two decades. PTSD patients can feel some hope.” – Berra Yazar-Klosinski, Chief Science Officer, MAPS Public Benefit Corporation
The Latest MDMA-Assisted Therapy Research
There have been a few recent studies examining the potential benefits of MDMA-assisted therapy. One was conducted in 2021 involving 90 patients with moderate to severe PTSD. In this randomized controlled study, two-thirds of those receiving MDMA and talk therapy no longer met PTSD criteria after 2 months. This compared with only a third of those receiving placebo and talk therapy alone. These results showed promise with treating PTSD with psychedelics like MDMA. However, this study was poorly diversified in its patient population. This is important since those with PTSD are more racially and economically diverse. Regardless, the study showed clear benefit with the addition of MDMA to current approaches.
A more recent study was just completed that better addressed the diversity issues. In this study, roughly a quarter of the participants were Hispanic and a third non-White. At the same time, the diversity of the therapists performing talk therapy was also notable. In this study involving 104 patients with moderate to severe PTSD, MDMA-assisted therapy was also beneficial. Of the treatment group, more than 85% had symptom reduction with 71% no longer meeting PTSD criteria. This compared with 69% and 48% respectively in the placebo group of participants receiving therapy alone. The results strongly support the notion that treating PTSD with psychedelics has future therapeutic potential.
“The benefits in the active group were really not much greater than the benefits in the placebo group. MDMA treatment would add huge costs to the treatment system while providing only a small, specific benefit — and thus result in a massive misallocation of already very scarce resources.” – Dr. Allen Frances, Professor Emeritus of Psychiatry, Duke University
Promising Results but Hurdles Ahead
From an objective perspective, treating PTSD with psychedelics like MDMA appears to be a potential mental health disruptor. This is why the research company, MAPS, plans to submit its findings for FDA approval. But this is only one obstacle that must be overcome before MDMA-assisted therapy can become mainstream. Like other drugs including marijuana and psylocibin, there are social barriers to consider. Many still see these medications as addictive and harmful regardless of their benefits in controlled settings. There are also additional issues related to cost, since MDMA-assisted therapy demands significant amounts of therapy time. Plus, therapists must be trained in treating PTSD with psychedelics in order to duplicate research results. Each of these represent noteworthy hurdles that advocates must address.
These are not the only barriers to MDMA-assisted therapy, as others like insurance reimbursement for care could also pose problems. Regardless, the research results certainly make these pursuits worthwhile. Additional research for MDMA-assisted therapy is already in the works, including longer-term studies. If additional results continue to show advantages of treating PTSD with psychedelics, then progress may be made. And for patients with PTSD and their families, this would be welcomed news.
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