MDMA-Assisted Therapy Can Help Treat PTSD, New Landmark Study Finds
On Venice Beach in Los Angeles, there’s a brick wall by the ocean where taggers showcase all kinds of messages for passersby to enjoy. But unlike the other spray paint messages, artist and chemistry professor Andrew Patalano recently wrote something different.
His art referred to MDMA, also known as molly or ecstasy. His message read “MDMA cures PTSD.”
“I feel passionate about it in particular because I think that a lot of these compounds could have been studied a lot more,” he says. “And it’s a crime that they are Schedule I [substances] compared to more dangerous compounds like alcohol.”
As a chemistry professor, Patalano is always thinking about compounds. So he says he was excited to read the latest study published in Nature Medicine on the first major trial on the effectiveness of using MDMA to help treat post-traumatic stress disorder.
Researchers say the initial findings are promising — but the study of MDMA has always come up against cultural stigmas as a party drug. In 2011, government statistics showed a 75% increase in ecstasy-related emergency room visits over a seven-year period, ABC News reported.
But under medical supervision, the authors of this landmark study say MDMA could prove beneficial when paired with therapy.
Jennifer Mitchell, a neuroscientist at the University of California, San Francisco, and the lead author of the study, says the study’s treatment began with participants undergoing a series of preparation work before receiving the MDMA.
Then for a full day, participants take the MDMA in a living room type space and return the next day for an intensive counseling session with a therapist, she says. Participants repeat this routine once a month for three months.
The therapists allow the MDMA and the participant to lead the way, meaning the therapists don’t ask prompting questions about the participant’s trauma, Mitchell explains. She calls this an “inner-guided therapy process.”
Mitchell says the study found participants who received MDMA in addition to therapy “experienced significantly greater reduction in PTSD symptoms and also in their symptoms of depression.”
PTSD has a range of traumas — combat trauma often associated with veterans’ experiences, racial trauma, sexual trauma and childhood trauma, for example. This study, which included different varieties of trauma, revealed MDMA was “equally effective” in certain extreme trauma subgroups that are considered “treatment resistant,” Mitchell says.
Participants had to taper off any of their other psychiatric medications in order for researchers to see the full impacts of MDMA, a downside of the study, Mitchell recognizes. That process was “destabilizing” for some participants who received the placebo, she says.
Fortunately, the study’s sponsors are reaching out to the placebo participants in order to give them an opportunity to receive the MDMA-assisted therapy in the future, she says.
One Participant’s Experience With The ‘Life-Changing Therapy’
Kanu Caplash is one of the patients who participated in the 2018 study while an undergrad at the University of Connecticut. Caplash, who received the drug instead of the placebo, says he signed up for the study as a last resort after trying and failing under traditional forms of therapy.
For years, he suffered from chronic nightmares, insomnia and hallucinations.
“It’s almost like your mind is like sending you little notifications through these nightmares and flashbacks to address something kind of deep in yourself,” he says.
After his first dose of MDMA, he says he was blindfolded and given headphones to help him block out his surroundings and fall into a meditative state. During that time, he recalls seeing visions that transported him to a new reality.
“It’s like a dream, but you’re a lot more aware,” he says.
This is not an unusual occurrence while taking the substance. People who have taken MDMA often talk about being able to see themselves more clearly with the ability to unpack their traumas without re-terrorizing themselves.
Caplash says he saw himself floating in space in front of a giant keyboard, where each key matched a different part of his life. Each key also held a memory, he says.
“One of the things that I’d always believed before I’d gotten into treatment for a long time was that I was going to die very early,” he says. “Because, you know, when you have PTSD, when a lot of your life is kind of filled with traumas to an extent, it makes it hard for one to believe that you’re actually going to live a long, happy life.”
In his vision, he says he saw himself running down the piano keys and living until he was 80 years old. The experience “shattered that belief entirely” that he’d die young, he says.
His therapist guided him through some other traumatic memories that came flooding back in. His recollections came back to him clearly, something his PTSD would usually blackout, he says.
It was important to have a medical professional present in order to work through these vivid traumas that he’s been living with, he says.
Now, in addition to regular talk therapy, he says he’s navigating who he is in the new world that “life-changing” MDMA-assisted therapy opened him up to.
Future Research On Psychedelic-Assisted Therapies
The study marks a turning point in getting approval from the Food and Drug Administration for this type of treatment. There have been other studies of psychedelics trying to treat depression and anxiety with lysergic acid diethylamide (LSD) and psilocybin mushrooms, commonly known as magic mushrooms.
Mitchell admits a lot more investigative research is needed to determine how exactly MDMA primes the brain for therapy.
In testing done in animals, she says “it’s pretty clear that MDMA has an impact on a brain region called the amygdala, where fear memories are typically stored and retrieved.”
Scientists assume a similar process happens in the human brain where MDMA allows people “access to memories that are very traumatic in nature and very hard to address or focus on, perhaps without a lot of shame and a lot of fear,” she says.
MDMA paired with therapy also somehow enables people to see their memories in a comfortable way that lets them process difficult recollections, she says.
This latest study of 90 participants produced no serious side effects. But before it can be approved for therapeutic use, the FDA needs a second positive Phase 3 trial. That trial, which has about 100 participants, is underway and should be up for approval in 2023.
FDA approval is only half of the battle. Stigma dating back to the 1960s and the criminalization of psychedelics has held back research for decades. Progress has been slow but fruitful in some places: Ballot measures to decriminalize certain psychedelics have passed in Oregon and Washington, D.C.
Researcher Mitchell hopes her recent study pushes people to take an objective look at the benefits of MDMA and other psychedelic therapeutics and concoct new therapies for those dealing with PTSD.
“There’s so many people that are suffering,” she says. “I think we can do better.”
Alexander Tuerk produced and edited this interview for broadcast with Jill Ryan. Serena McMahon adapted it for the web.
This article was originally published on WBUR.org.
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