A combination of therapy and the psychedelic drug MDMA helped alleviate PTSD symptoms in a phase III trial.
Post-traumatic stress disorder (PTSD) affects approximately 6% of the world’s population. The psychiatric disorder usually develops in people who have experienced or witnessed a traumatic event such as war, disaster, sexual or physical violence, or serious injury. Symptoms can vary from flashbacks, depression, detachment to self-destructive behavior. Treatment often involves a combination of medications and psychotherapy sessions. However, these are not always effective for all patients. Therefore, scientists are on the search for new therapies with better outcomes. Recently, a group of researchers at University of California, San Francisco, reported findings from a phase III trial that evaluated the effect of MDMA on PTSD symptoms. They presented their results at the spring meeting of the American Chemical Society (ACS).
In recent years, the interest in psychedelics such as psilocybin, LSD, and MDMA has greatly increased. Scientists have explored their use in treating psychiatric disorders such as depression.
The psychedelic MDMA, also known as ecstasy or molly, is a common recreational drug. Due to its effect on the amygdala, a brain region involved in regulation emotions and processing fear, researchers hypothesized that it can likely increase the effectiveness of psychotherapy in treating PTSD. Hence, they enrolled 90 people with severe PTSD. In addition to the weekly therapy, the participants also received two 8-hour therapy sessions a month apart. Half of the patients received MDMA prior to the session, while the other half received a placebo.
MDMA is really interesting because it’s an empathogen. It causes the release of oxytocin in the brain, which creates feelings of trust and closeness that can really help in a therapeutic setting.
Dr. Jennifer Mitchell, principal investigator
Better Than SSRIs
Two months after the last therapy session, two-thirds of the participants in the MDMA group no longer met the clinical criteria for PTSD. In comparison, only one-third of the control group had a similar effect. Thus, suggesting that MDMA fares better than selective serotonin reuptake inhibitors (SSRIs).
Moreover, study authors did not notice any signs of addiction among the treatment group, and side effects were also minimal. According to the principal investigator Dr. Jennifer Mitchell, the psychedelic also proved effective at treating patients who are resistant to traditional PTSD treatments, such as those with alcohol or substance use disorder. However, the study authors are not in favor of self-medicating with MDMA.
If MDMA is decriminalized, that doesn’t mean it’s safe. It can be a very powerful tool, but it needs to have the right dose in the right context with the right support system.
Dr. Jennifer Mitchell, principal investigator
The team is currently recruiting participants for a second phase 3 trial. They hope to receive an FDA approval for MDMA-assisted therapy for PTSD by next year.
Reference:
Mitchell, J.M., Bogenschutz, M., Lilienstein, A. et al. MDMA-assisted therapy for severe PTSD: a randomized, double-blind, placebo-controlled phase 3 study. Nat Med 27, 1025–1033 (2021). https://doi.org/10.1038/s41591-021-01336-3
