Therapy with Ecstasy; treating post-traumatic stress disorder

Right now, millions of people are suffering from post-traumatic stress disorder (PTSD) worldwide. Up to 10% of the population of the US will suffer from PTSD in their lifetime 1. PTSD can develop after any kind of trauma, most commonly sexual assault or combat experience. People with PTSD may find it hard to function normally, re-experiencing their trauma in frequent waking nightmares. It can lead to depression, drug abuse, and even suicide in many cases.

ptsd-depressed-320x202

PTSD is a real struggle for healthcare professionals to treat, with various therapeutic and drug-based approaches having limited benefit. Many PTSD patients are resistant to commonly used therapies, and may develop a chronic form of the disorder 1.

The stimulant drug Ecstasy, or MDMA, is most commonly known for its use as a party drug. But MDMA was originally used as a tool for psychotherapy in the 70s and 80s. Psychotherapists used MDMA to induce an easily controllable emotional state that enhanced communication with their patients 2. Use of MDMA in psychotherapy became a well-kept secret, with therapists constantly in fear that their miracle drug would be taken away by the DEA. Very little was published on MDMA around this time, but private correspondence was circulated around psychotherapists for years, hailing this new unique therapy drug.

But it wouldn’t last. MDMA leaked into recreational use, authorities became aware of its existence, and it was made illegal in the US in 1985. Its use as a psychotherapeutic wonder-drug was abruptly halted.

MDMA ban

Newspaper headlines from May 1985

That is, until recently. Convinced that thousands of psychotherapists had been onto something, a group in the US decided to investigate MDMA’s therapeutic potential in a pilot study 1. 20 patients suffering from acute PTSD, most of them victims of sexual assault, were recruited for the study. They had all failed to respond to previous treatments and therapy and, on average, had been suffering from PTSD for over 19 years.

In a double-blind, placebo-controlled experiment, these subjects were given MDMA during long, thorough therapy sessions, overseen by healthcare professionals and administered by psychotherapists. After these sessions, the patients were measured for PTSD symptoms using two widely accepted tests.

Psychotherapy

MDMA is thought to enhance a patient’s communication with their therapist.

As little as three days following the therapy, patients that had taken MDMA had significantly lowered PTSD scores compared to the placebo group. Amazingly, 10/12 of the patients who had been given MDMA-assisted psychotherapy no longer met PTSD criteria, meaning they were free of the disorder after many years of suffering. Three subjects, who had previously been unable to work due to the condition, were able to return to work as a result of the MDMA-assisted psychotherapy.

MDMA

These results are impressive enough; but the same group performed a long-term follow-up study and found that most of these patients (74%) had remained PTSD-free several years down the line 3. The authors state that these positive effects are an improvement from typical PTSD treatments.

As with all pilot studies, there are various flaws in the design, mostly relating to the small number of patients. MDMA is not a miracle drug; in this case, both the experimenters and the patients strongly believed that the controlled therapeutic environment was crucial in the success of the trial. Without guided, professional therapy, MDMA self-administration could do more harm than good.

However, this study demonstrates that psychedelics, when used appropriately and with respect, have great medical and psychological potential. It’s a reason for the millions suffering from treatment-resistant PTSD around the world to be hopeful for the future.

 

References

  1. Mithoefer et al. (2010) The safety and efficacy of MDMA-assited psychotherapy in subjects with chronic, treatment-resistant PTSD: the first randomized controlled pilot study. J Pharmacol, 25(4):439-452.
  2. Pentney (2001) An exploration of the history and controversies surrounding MDMA and MDA. J Psychoactive Drugs, 33(3):213-221
  3. Mithoefer et al. (2013) Durability of improvement in PTSD symptoms and absence of harmful effects or drug dependency after MDMA-assisted psychotherapy: a prospective long-term follow-up study. J Pharmacol, 27(1):28-39
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