MDMA for PTSD

A lengthy article in last weekend's Washington Post Magazine discusses the work of Michael Mithoefer, a psychiatrist at the Medical University of South Carolina (MUSC) who has almost completed the first phase of a clinical study into the use of ecstasy as a therapeutic tool for post-traumatic stress disorder.

Ecstasy (MDMA, or 3,4-methylenedioxy-N-methylamphetamine) is a psychedelic and a stimulant which acts by inhibiting the reuptake of serotonin, and, to a lesser extent, of dopamine and noradrenaline. It is illegal in most countries (it is classified as a Class A drug in the U.K. and a Schedule I drug in the U.S.), but its popularity as a recreational drug has increased dramatically since the late 1980s.

During the 1950s, research into the use of psychedelics for treatment of various psychiatric conditions was not uncommon, and many therapists believed that the drugs were of great potential benefit. In the early 1960s, however, such studies ceased almost entirely, after widespread recreational use of the substances led to their criminalisation.

Interestingly, the Washington Post article lays the blame for this dramatic decline in research single-handedly Timothy Leary, who started off doing serious research into LSD but became the drug's biggest advocate, and the new-age guru and icon for the LSD counterculture. Ironically, recent historical research has revealed that a number of these early studies showed that LSD is effective in treating alcoholism.

Mithoefer's study, which is the first of its kind in over 20 years, is sponsored by the Multidisciplinary Association for Psychedelic Studies (MAPS), a non-profit organization whose proposed 5-year, $5 million plan for research into MDMA-assisted psychotherapy for PTSD was approved by the Food and Drug Administration in 2001.

Following further approval by the Drug Enforcement Administration in 2004, Mithoefer commenced his study in April 2004, by recruiting 21 women who suffered from otherwise untreatable PTSD as a result of rape or other forms of violence.

One of the first patients enrolled in the study was Donna Kilgore, whose case is documented in the Washington Post article, together with Mithoefoer's preliminary, unpublished findings. Although the initial results are promising, some PTSD researchers are skeptical, because the data have not yet been analyzed statistically. Others criticize the DEA's decision to approve the study, as the extent of MDMA's neurotoxicity is yet to be determined.

Nevertheless, Mithoefer is convinced that MDMA is an effective treatment. The first stage of his study is almost complete, with 18 of the 21 patients having undergone double-blind MDMA-assisted psychotherapy sessions. 2 Iraq war veterans, both with PTSD, have already been cleared to take part in the second stage of the study.

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What an interesting article, but it leaves me with one question, and that is how the "comedown" is managed. I'm not a scientist, so forgive me if this is a stupid question, but even though the neurochemistry of those suffering from PTSD is different from those suffering depression, how does the resultant serotonin depletion effect them? Wouldn't they be more vulnerable to the negative after-effects, even if they are temporary?

cerebralmum: Serotonin depletion caused by MDMA can be prevented by using an SSRI, preferably with a long half-life. I'm not sure if they did use it in this case, but it's not unlikely that these patients were already on Prozac.

This study looks very promising. Thanks for blogging about it Mo.

By sam mirshafie (not verified) on 29 Nov 2007 #permalink

I suffer from PTSD and used anti-depressants and an anxiety medication for panic attacks. When I was much younger and in the club scene, I did experience MDMA in it's almost purest form. That was in the early 90s. Back then it was recreational, but I would really like to tap into it legally for my and my husband's marital issues and PTSD we suffered after having our firstborn. When we would take it together all I could feel was love and all my fears were torn down while under the influence. We did it a few times and did have some therapeutic sessions of our own. It helped us in those early years, even though it was from the underground and we could never trust its authenticity.

I really hate that it became a Schedule I drug because it was highly beneficial for us in the early years when we "did" have the beginning stages of marital problems. We eventually worked things out, but after years and years of burying those feelings deep inside, we finally sought counseling. I was very surprised to see it embraced by the American Psychiatry Association, as I am currently in psychotherapy.

I think it's worth starting the research and medical advised use started over again.

thank you for posting everyone including professionals told me this type of studies had never been done thank you for validating me!!!!