The Grapevine

MDMA Therapy For PTSD Is Effective But Addiction Concerns Linger

After being banned in the 1980s, MDMA has risen again in recent years as an unconventional aid against trauma. Now, researchers announced promising results after studying the use of MDMA combined with psychotherapy for treating post-traumatic stress disorder (PTSD).

The clinical trial was approved by the U.S. Food and Drug Administration (FDA), was funded by the Multidisciplinary Association for Psychedelic Studies (MAPS), and the findings were published in the journal The Lancet Psychiatry on May 1.

Why MDMA?

In previous research, MDMA (or 3,4-methylenedioxymethamphetamine) has been shown to “catalyze the therapeutic processing of traumatic memories and thereby relieve PTSD symptoms,” explained researcher Allison Feduccia, a clinical data scientist at MAPS Public Benefit Corp. in California.

Users have reported it helps in reducing fear by creating feelings of trust and well-being. The researchers said this effect allowed patients to re-examine traumatic memories, but only if taken between month-long intervals and combined with therapy. 

“The MDMA seems to act as a catalyst that allows the healing to happen,” said lead researcher and psychotherapist Dr. Michael Mithoefer.

What were the methods and results of the study?

Participants included 22 veterans, 3 firefighters, and 1 police officer, all of whom were suffering from service-related PTSD lasting longer than six months. Along with psychotherapy, the participants received MDMA orally in a dose of either 30, 75 or 125 milligrams. 

A month later, 68 percent of participants in the high-dose groups no longer met diagnostic criteria for PTSD, compared with the low-dose group. One year later, 67 percent of all the participants did not qualify for a PTSD diagnosis.

But, researchers also observed a few side effects such as anxiety, fatigue, and insomnia. Only one serious side effect (extra beats in one chamber of the heart) was attributed to the treatment. However, the patient was able to recover after an overnight stay at the hospital, according to the study.

What are the possible risks of using MDMA in treatment?

While many from the medical community have supported MDMA-assisted psychotherapy as a "breakthrough" form of treatment, other experts are still apprehensive about the therapeutic potential as there are “definitely some issues that should be addressed before it is to be used as a co-drug for psychotherapy,” as stated by Psychology professor Andrew C. Parrott of Swansea University in the U.K.

Parrott explained how the unpredictability of MDMA is a major drawback, especially when predispositions to anxiety or depression exist. There is a risk of triggering an addiction in such patients. He also added the “comedown” from the drug could result in temporary periods of negative moods, thus becoming counter-productive.

Dr. Philip Cowen, a professor of psychopharmacology at the University of Oxford, U.K., emphasized larger trials need to reflect the findings as the current study was small in size. 

“The take-home message is to wait for the results of the latter studies, and if you have PTSD, don't try this at home,” he added, as taking street ecstasy without medical supervision could also lead to addiction among other risks.

Feduccia added larger clinical trials with 200 to 300 patients were scheduled to begin soon. If these trials are successful in demonstrating the safety and efficiency of MDMA, the approval of the treatment by the FDA can be expected by 2021.

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