Can MDMA Help Patients with PTSD?

October 2, 2019

The potential benefits of ecstasy-influenced memory reconsolidation.

Recent media reports describe medical professionals treating patients with MDMA (3,4-methylenedioxymethamphetamine) to combat post-traumatic stress disorder (PTSD). This may seem like an unorthodox approach or the musings of a few fringe figures. While unorthodox, neither is the case. The treatment has been rigorously tested, and the United State Food and Drug Administration (FDA) has allowed the treatment to progress to Phase 3 clinical trials. It has also received Breakthrough Therapy status.

While the potential dangers of MDMA are very real and the recreational use of the drug remains illegal and not recommended, medical professionals who have made limited use of the drug in conjunction with psychotherapy while treating PTSD have reported significant results. One of the most notable studies, which involved 26 veterans and first responders who were diagnosed with chronic PTSD, found that 52.7 percent of participants who were given active doses of MDMA (75-125 mg), and then participated in therapy sessions involving two therapists, one male and one female, no longer met the criteria for PTSD at the primary endpoint of the study. This was more than double the rate when compared with participants in the control group (22.6 percent). Symptom reduction was reported as long as 3.5 years following the trial.

What is MDMA?

MDMA is a psychoactive substance that promotes the release of neurotransmitters like dopamine, serotonin, and norepinephrine, as well as neurohormones, most notably oxytocin. As MDMA is an amphetamine derivative, it produces effects similar to other stimulants, such as cocaine. However, its more salient effects involve a heightened sense of empathy or connectivity to others, euphoria, and reduced fear responses.

MDMA is commonly referred to as ecstasy, molly, or E. It was criminalized in 1985, and then designated as a Schedule I drug by the Drug Enforcement Agency in 1986. According to the DEA, such a designation means that the drug has “no currently accepted medicinal use and a high potential for abuse.” Other Schedule I drugs include heroin, LSD, and peyote.

The fact that MDMA is considered to be a potentially dangerous drug is beyond repute. Individuals who are experiencing the acute effects of the drug may engage in reckless behavior that is potentially life-threatening. Additionally, MDMA modestly increases blood pressure and body temperature (hyperthermia). While not particularly life-threatening in isolation, this phenomenon can lead to heat stroke if an individual is rigorously dancing at a party or nightclub. As illicit MDMA continues to have a strong presence at dance clubs, this is not an uncommon occurrence.

Frequent use can produce more pernicious effects, interfering with concentration, sleep, and appetite. Heavy use can lead to depression, heart disease, and decreased cognitive function. However, addiction is uncommon. The Diagnostic and Statistical Manual of Mental Disorders (DSM-V) claims that it is one of the rarest substance use disorders.

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