Under the Hood

MDMA Shows Trust Rebuilding Potential In People, Study Finds

When a person suffers from posttraumatic stress disorder, they commonly experience trust issues and distance themselves from others. The primary treatment for the condition involves psychotherapy, at times combined with medication.

Approved medications may improve symptoms such as nightmares and poor concentration. But treating problems related to social processing have been more challenging.

But researchers at King's College London have found the drug MDMA could help people rebuild their trust without becoming gullible. The findings were published in the Journal of Neuroscience on Nov. 19.

"Understanding the brain activity underlying social behavior could help identify what goes wrong in psychiatric conditions," said senior author Mitul Mehta, a professor from the Institute of Psychiatry, Psychology & Neuroscience. "Given the social nature of psychotherapy, understanding how MDMA affects social interaction sheds light on why the drug could become a valuable tool in treating patients."

Being a stimulant, it is known MDMA can elevate mood by inducing and enhancing peacefulness, confidence, empathy, sexual desire, and more. The drug was dangerous for several reasons including the troubling withdrawal symptoms, concerns over contamination, the risk of organ failure, etc.

In the new study, the drug was given in a controlled laboratory setting. Twenty healthy adult men were recruited as participants — while some received a dose of MDMA, others received a placebo pill.

Next, the men were instructed to play a game where they could either work together or against another player. To make this decision, they had to gauge the trustworthiness of the other player.

They found participants under the influence of MDMA could cooperate and rebuild their trust even after being betrayed by trustworthy players. But they did not become gullible enough that they cooperated with untrustworthy players.

"We asked people what they thought of their opponent and, surprisingly, MDMA did not alter how trustworthy they thought the other players were. Untrustworthy players were rated as low on the scale, whether on MDMA or placebo, and trustworthy players were given equally high ratings," Mehta explained. "Importantly, MDMA did not cause participants to cooperate with untrustworthy players any more than normal. In other words, MDMA did not make participants naively trusting of others."

The Food and Drug Administration has granted “Breakthrough Therapy Designation” for MDMA used alongside psychotherapy for the treatment of PTSD. Currently, it is undergoing phase 3 clinical trials.

In the United States, an estimated 8 percent of adults were said to have PTSD at any given time. Women were also more likely to develop the condition than men. As researchers get a better insight into brain activity underlying social behavior, it was not only PTSD but many other psychiatric conditions that could see more effective treatments being developed.