In recent years, medicine has revealed a groundbreaking shift in the landscape of mental health treatment, with researchers investigating unconventional avenues to address conditions that have long eluded traditional therapies. Among these explorations, the use of 3,4-methylenedioxymethamphetamine, formally known as MDMA, has emerged as a promising candidate for revolutionizing the treatment of post-traumatic stress disorder (PTSD). However, how credible is this seemingly "miracle" drug?
Origin:
In 1912, a German pharmaceutical company birthed MDMA, originally named "Methylsafrylaminc," intending it to serve as a drug to control extensive bleeding, unlike the prevalent modern usage for appetite supression. Fast forward to the late 1970s and early 1980s, and MDMA found favor among psychiatrists, raved for its communication enhancement and release of serotonin, despite lacking formal clinical trials and FDA approval. Simultaneously, it began its journey from clinical circles to the streets.
Clinical Trials:
From suspect linkage to suppressing symptoms of PTSD, MDMA was first clinically tested in the trials by MAPS (Multidisciplinary Association for Psychedelic Studies). MAPS conducted a series of Phase 2 clinical trials investigating the safety and efficacy of MDMA-assisted therapy for individuals with PTSD. Notably, the trial published by Michael C. Mithoefer and Annie Mithoefer in the Journal of Psychopharmacology in 2010 garnered significant attention. This randomized, double-blind, placebo-controlled study involved participants with chronic, treatment-resistant PTSD. The results of this trial indicated that individuals who received MDMA-assisted therapy experienced significant reductions in PTSD symptoms compared to those who received a placebo. The therapy sessions involved guided psychotherapy combined with the administration of MDMA in a controlled and low dosage.
Science of MDMA
At this point, you might be asking how does ecstasy even work? MDMA operates by releasing neurotransmitters—chemical messengers that alter brain activity and make you generally happy. These include dopamine, serotonin, and norepinephrine, known as "feel-good" hormones, along with oxytocin, prolactin, cortisol, and vasopressin. The resulting effects include feelings of empathy, heightened self-awareness, sensory pleasure, increased energy, reduced anxiety, and an enhanced ability to express emotions. Moreover, users may experience shifts in perception of time and space. Mental health experts suggest that these emotional responses create an optimal environment for individuals with PTSD to engage in open discussions about challenging emotions, engage in self-reflection, and address the events that may have contributed to their condition.
Side Effects:
It's important to note that the use of MDMA also poses risks of more severe and life-threatening effects, especially when taken in high doses or in combination with other substances. These can include serotonin syndrome, seizures, and cardiovascular complications. Long-term use of MDMA has been associated with potential neurotoxic effects, particularly affecting serotonin-producing neurons in the brain, but more research is needed to fully understand the extent of these effects. Given the risks associated with MDMA use, including the potential for harm, it's crucial for individuals to be aware of these side effects and for healthcare professionals to provide accurate information and support for those seeking help with substance use issues.
To put it short, while there is evidence for the usage of MDMA in low dosage along with medical supervision, there is still a long way for its approval as a "cure" for PTSD under FDA guidelines. Despite the promising results produced multiple times in research and clinical trials, there is still an overbearing need for a phase 3 trials on side effects and possible concerns regarding the performance of the drug in larger sample sizes. However, it is an interesting possible solution for a disorder affecting 13 million Americans today.
Sources:
Assessed and Endorsed by the MedReport Medical Review Board