MDMA-Assisted Psychotherapy

2017 the U.S. Food and Drug Administration (FDA) granted Breakthrough Therapy Designation to MDMA for PTSD. Ultimately, this made it the first psychedelic-assisted psychotherapy evaluated in phase three trials for possible prescription use. Presently, ten clinics in the United States offer expanded patient access to MDMA Assisted Psychotherapy, with the possibility of full FDA approval by 2023 (MAPS).

So what is MDMA, and what’s it all about? Let us break it down for you.

 History of MDMA

Known initially as Methylsafrylaminc, MDMA was created in 1912 by German chemists for pharmaceutical purposes. Explicitly this was while developing medicines that could stop bleeding.

Because of its unique psychoactive properties, Merck patented MDMA in 1914 (History).

During the Cold War, the U.S. Army and the CIA used MDMA and other hallucinogenic drugs as psychological weapons for mind control.

Chiefly referred to as ecstasy or molly, some psychiatrists in the 1970s used MDMA to help patients communicate and participate in psychotherapy. Later, it became a widely used street drug in the 1980s. As a result, the FDA declared it illegal in 1985.

Effects of MDMA

A stimulant and an entactogen, MDMA produces feelings of empathy, connectedness, and love. Similarly, it can create a sense of euphoria for the user. The drug can also cause heart rate and blood pressure spikes and raise a user’s body temperature.

As an entactogen, MDMA causes the release of oxytocin in the brain, creating feelings of trust. Accordingly, it’s also shown to help process memories in an area of the brain called the amygdala (Mitchell, ACS). Both of these characteristics make MDMA-Assisted Psychotherapy ideal for mental health treatment. Additionally, it can be a powerful tool in helping people with long-term trauma or PTSD.

PTSD & MDMA

Posttraumatic stress disorder (PTSD) is “a psychiatric disorder that occurs in people who have experienced or witnessed a traumatic event such as a natural disaster, a serious accident, a terrorist act, war/combat, or rape or who experience death, sexual violence or serious injury” (APA).

Furthermore, PTSD is a condition associated with reduced cognitive and psychosocial functioning. When not adequately treated, PTSD can be a long-lasting and life-threatening condition. Consequently, those with PTSD may experience nightmares and flashbacks, depression, engage in substance use, and feel detached. Additionally, they can be unable to maintain employment or relationships.

Facts on PTSD

● Approximately 7% of the U.S. population, and 11-17% of U.S. military veterans, will have PTSD sometime in their life

● As of June 2016, more than 868,000 veterans were receiving disability compensation for PTSD

● In the general population, 27% of suicides are associated with PTSD

● PTSD affects approximately 3.5 percent of U.S. adults every year

● An estimated 1 in 11 people will be diagnosed with PTSD in their lifetime

● Women are twice as likely as men to have PTSD

● U.S. Latinos, African Americans, and American Indians – are disproportionately affected and have higher rates of PTSD than non-Latino whites

What is MDMA-Assisted Psychotherapy?

According to the Multidisciplinary Association for Psychedelic Studies (MAPS), MDMA-Assisted Therapy is a “treatment package combining psychotherapy with the administration of MDMA (approved generic name: midomafetamine) to achieve significant and lasting reductions in PTSD symptoms” (MAPS).

A three-single-dose psychotherapy session process is standard. Sessions occur three to five weeks apart and include preparatory and integration sessions.

Phase Two clinical trials show that:

● reduce fear and defensiveness

● enhance communication and introspection

● increase empathy and compassion.

According to MAPS, “The combination of these neurological effects can enhance the therapeutic process for people with PTSD.”

MAPS is a 501(c)(3) nonprofit research and educational organization that develops medical, legal, and cultural contexts for people to benefit from the careful uses of psychedelics and marijuana.

Founded in 1986, the organization operates two expanded patient access sites in the U.S. In phase three clinical trials, MDMA-assisted psychotherapy improved PTSD symptoms after three sessions.

Dr. Raymond Turpin, a psychologist with one of the MAPS expanded access patient sites (the nonprofit Pearl Psychedelic Institute), explains that treatment with MDMA effectively shuts down the brain’s fight-or-flight responses, allowing traumas to come to the surface of consciousness so it can be appropriately processed.

Turpin contends that results from phases two and three showed 67% of participants no longer showed PTSD symptoms, which is promising compared to the loose 50% success rate of antidepressant treatment (BPR).

Looking to the Future

Showing promising results for treating PTSD, MDMA can dramatically transform the future of PTSD, depression, and anxiety treatments. In addition to MAPS’ study of MDMA treatment for PTSD, they also explore its use for social anxiety in Autistic adults, anxiety associated with life-threatening illnesses, and eating disorders (MAPS).

Sources

● MAPS: FDA Grants Breakthrough Therapy Designation for MDMA-Assisted Therapy for PTSD, Agrees on Special Protocol Assessment for Phase 3 Trials
● MAPS: MDMA-Assisted Therapy for Eating Disorders (MED1)
● History.com: MDMA
● American Chemical Society (ACS): A psychedelic drug, combined with intense therapy, improves PTSD symptoms
● APA: What is Posttraumatic Stress Disorder (PTSD)?
● NIDA: What is the history of MDMA?
● Blue Ridge Public Radio (BPR): FDA gives expanded access to MDMA as a treatment for PTSD