Post-traumatic stress disorder can cause intense anxiety or panic attacks if you recall memories of physical or sexual assault.
In the US, about seven percent of people suffer from Post Traumatic Stress Disorder and lose an average of four working days a month. Cognitive processing or "talk" therapy is a cornerstone of treatment for trauma.
For approximately half of people, traditional approaches are not effective at fully addressing the symptoms of post-traumatic stress disorder. The effects of anti-depressant drugs are usually modest.
MDMA is an active ingredient in ecstasy. People in dance clubs and raves use MDMA because of its effects on mood and energy levels, as well as the feeling of bonding with others.
The effects of these same effects on people with post-traumatic stress disorder have been shown to support them during therapy. The benefits of MDMA-assisted psychotherapy in the treatment of post-traumatic stress disorder have been confirmed by a new meta-analysis.
The benefits and harms of substances of abuse like bath salts, phenibut, cannabis and synthetic marijuana are investigated by a team of doctors and a pharmacist. Through this work, we have become interested in the therapeutic potential of some drugs in the treatment of mental illnesses, from major depression to post-traumatic stress disorder.
MDMA needs to be used along with carefully crafted psychotherapy in a safe, controlled environment in order for ecstasy or molly products to help with the symptoms of post-traumatic stress disorder.
It is impossible to give a proper dose of MDMA to someone with Post Traumatic Stress Disorder because ecstasy or molly products never specify the exact amount of MDMA they contain. MDMA can cause heart attacks, strokes, seizures, and arrhythmias, and can damage muscles and kidneys, if taken too much.
MDMA-assisted psychotherapy is what it is.
Patients take MDMA as a pill and then work with a team of therapists who help them reveal traumatic events or discuss aspects of those events over the course of several hours. They know what to expect from non-MDMA sessions. They have at least one non-MDMA session after each MDMA to work through the traumatic memories that were revealed and learn how to cope.
There are two or three MDMA-assisted psychotherapy sessions included in a standard treatment course.
The MDMA products used in these sessions are pharmaceutical grade. Unlike street products that are obtained illegally, they do not contain other substances of abuse, such as meth or heavy metals.
People with high blood pressure or who are at high risk of heart attacks, strokes or arrhythmias should not participate. Patients are not allowed to leave until the effects of MDMA have dissipated.
The effectiveness of MDMA-assisted psychotherapy is assessed.
We reviewed the available animal data and the few preliminary human studies of MDMA-assisted psychotherapy, but they had not yet been completed. In the past few years, larger and higher-quality trials have been published.
We recently reviewed the data and performed a meta-analysis study of the six different clinical trials that assessed the usefulness of MDMA-assisted psychotherapy versus psychotherapy alone. Men and women who had experienced a lot of traumatic events were included in all of the trials.
The studies used the same points scale to determine the effectiveness of therapy, making it easier to compare data. A patient with scores over 50 points is considered to have severePTSD and scores less than 10 points from baseline are clinically meaningful.
We found that daily antidepressant therapy reduced post-traumatic stress disorder by 6 to 14 points compared with placebo, but a range of 27 percent to 47 percent of patients withdrew before the end of the trials. MDMA-assisted psychotherapy reduced the scores by 22 points compared with placebo, and patients were twice as likely to no longer meet the criteria for a diagnosis of post-traumatic stress disorder by the end of the trials.
Only eight percent of patients withdrew from MDMA-assisted psychotherapy trials. The main adverse effects were headaches, nausea, and teeth grinding. One of the MDMA trials found that participants' blood pressure and heart rate were elevated in the course of MDMA therapy.
The long-term impact of several trials in our meta-analysis was assessed by sending a questionnaire to participants 12 months after their last MDMA session. 86 percent of participants said they received substantial benefits from the combined MDMA-assisted psychotherapy.
Eighty-four percent of participants reported having improved feelings of well-being, while 71 percent had fewer nightmares, 69 percent had less anxiety and 66 percent had improved sleep. The results from all of the studies suggested that MDMA-assisted therapy was helping to alleviate the symptoms of post-traumatic stress disorder.
Looking ahead.
The US Drug Enforcement Administration has a list of controlled substances. The substances have no currently accepted medical use in the US and have high abuse potential.
An important exception is worth noting. Cannabidiol is a drug that is classified as a Schedule I drug. The FDA approved its use for the treatment of two rare and severe childhood seizure disorders.
That doesn't mean that the benefits of the cand can be seen by most of the ills people are using it for, but the full therapeutic potential of the cand is still being explored. We think that MDMA-assisted psychotherapy will become an FDA-approved option for post-traumatic stress disorder by the end of the year.
The hallucinogenic mushrooms show promise for treating major depression, but more research is needed.
The possession of Schedule I drugs in research settings was criminalized by the Drug Enforcement Administration, making it hard for scientists to conduct research on them. The application process for obtaining a waiver for research was streamlined in the year.
It was easier for researchers to conduct trials into the pharmaceutical value of drugs. Within the next decade, this shift will accelerate the discovery of new treatments for patients with mental illness.
The Department of Pharmacy Practice at the University of Connecticut is headed by C. Michael White.
The Conversation's article is a Creative Commons licensed one. The original article can be found here.
