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MDMA-Assisted Psychotherapy May Help Patients With Severe PTSD, Study Finds



Military combat veterans and other patients with treatment-resistant post-traumatic stress disorder (PTSD) may find symptom relief through psychotherapy that involves the use of MDMA, a new scientific review finds.

“MDMA-assisted psychotherapy demonstrated a high rate of clinical response, remission, with a large effect size at reducing the symptoms of PTSD,” the paper states. “Available evidence indicates that MDMA was well-tolerated, with few serious adverse events reported across studies.”

In other words, the authors write, this type of therapy “appears to be a potentially safe, effective, and durable treatment for individuals with chronic, treatment-refractory PTSD.”

Current options for dealing with severe chronic PTSD are limited. A growing body of research, however, suggests that MDMA (which is restricted as an illegal Schedule I substance) has therapeutic potential when used in a medical setting. To assess where that evidence currently stands, researchers in Canada conducted a systematic review of randomized controlled trials involving the administration of this psychoactive substance.

Their findings were published last week in the journal Progress in Neuro-Psychopharmacology and Biological Psychiatry.

The study’s authors reviewed research published up to December 2018. They focused on trials that involved participants who’d been diagnosed with PTSD or appeared to have chronic PTSD based on how long their reported symptoms lasted, and involved the use of MDMA (familiarly known as “ecstasy” and formally called 3,4-methylenedioxymethamphetamine) with the intention of reducing symptoms associated with the mental disorder.

Ultimately, the authors narrowed their analysis to five studies with a total of 106 participants. That research was conducted in primarily outpatient settings and spanned from 2004 to 2017. The majority of participants were female (69 percent). All five studies offered MDMA-assisted psychotherapy to participants in an experimental group, and the dosage of the substance ranged from 50 mg to 125 mg.

Here are the review’s overall findings:

  • A majority of patients responded to MDMA-assisted psychotherapy. Seventy-two percent of those who received MDMA treatment saw a clinical response, compared to 19 percent in the control group.
  • The number and severity of PTSD symptoms among patients improved significantly after MDMA-assisted psychotherapy: “The overall standardized mean difference for the change in PTSD symptom scores pre-versus-post intervention was 1.30, indicating a large effect size,” the review’s authors wrote.
  • During follow-up, researchers found the effects had persisted: According to the paper, “as little as 2 or 3 sessions of MDMA-assisted psychotherapy were found to last several months after the completion of the intervention.”
  • How well MDMA works, and at what dosage, is still unclear: One trial included in the review did not find “statistically significant reductions” when researchers rated patients objectively, though subjective PTSD ratings had improved. In another clinical trial, patients who consumed 75 mg and 125 mg of MDMA had “significantly greater decreases in PTSD symptom severity” than those who consumed 30 mg.
  • As for safety concerns, four out of five studies reported no adverse effects.

“Collectively,” the authors wrote, “these results support MDMA-assisted psychotherapy’s short- and long-term effectiveness for the treatment of PTSD.”

Researchers think that MDMA’s effectiveness for people dealing with PTSD may have something to do with its ability to reduce some of the negative effects of recalling a traumatic event, such as anxiety, fear and feeling overwhelmed. The psychedelic substance also appears to enhance mood, empathy and pro-sociability, making it easier for patients to talk with a trained professional about their experiences.

“Facilitating the fear-extinction process is widely cited as one of MDMA’s potential therapeutic mechanisms,” they wrote. “Under careful medical supervision and with specialized psychotherapy, a few sessions that include MDMA pre-treatment appear to facilitate the recall of traumatic memories without the user feeling overwhelmed by the negative affect that usually accompanies such memories.”

More clinical trials involving the use of MDMA during therapy are currently underway. Importantly, however, key federal agencies recently indicated they have no plans to reclassify any psychedelics currently listed as Schedule I—including MDMA.

Federal Health Agencies Acknowledge Therapeutic Potential Of Psychedelics

Photo courtesy of Pretty Drugthings/Unsplash.

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Kimberly Lawson is a former altweekly newspaper editor turned freelance writer based in Georgia. Her writing has been featured in the New York Times, O magazine, Broadly, Rewire.News, The Week and more.


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