MDMA Therapy Offers New Hope for Women with PTSD

Psychedelic drugs, known for their mind-altering effects, are getting a rebrand and gaining popularity for their potential mental health benefits. Research continues to look into shrooms for OCD, ketamine for depression, and now, MDMA (or ecstasy or molly) for post-traumatic stress disorder (PTSD). 

Results from a clinical trial published in September found that the synthetic drug was effective at reducing symptoms of PTSD, a disorder that an estimated 10% of women will experience at some point in their lives and one that's up to three times more common in women than men.

How MDMA-assisted therapy may help women with PTSD

PTSD can result in a cascade of devastating issues, including eating disorders, depression, substance abuse, and suicide, if it's not treated properly. Current treatment options (talk therapy and antidepressants) are decades old, and it's estimated that they may not work in about 33% of patients, making the discovery of MDMA for this use case a major breakthrough. In the clinical trial, nearly 87% of patients who received MDMA-assisted therapy saw their PTSD symptoms lessen significantly, with 71% of participants having no clinically diagnosable PTSD following treatment. 

MDMA promotes the release of neurotransmitters in the brain, including serotonin, norepinephrine, dopamine, and the hormone oxytocin, which help regulate everything from your heart rate and blood pressure to your energy levels and mood. The flood of all these chemicals together induces feelings of bonding, closeness, communication, and self-compassion, according to Jennifer Mitchell, PhD, a neuroscientist at the University of California, San Francisco, and the trial's lead author. But it's not just about the physical effects of the drug — "rather, it's the result of an interaction between the effects of the medicine, the therapeutic setting and the mindsets of the participant and the therapists," according to a treatment manual written by the Multidisciplinary Association for Psychedelic Studies (MAPS) a nonprofit group involved in psychedelic research.

The concept of MDMA-assisted therapy is that, when coupled with traditional talk therapy, the drug may give patients the ability to work through traumatic memories when they bubble up and perhaps even release some of the heavy emotions tied to them, explains Mitchell. "So it's not like you forget the memory, but it doesn't maybe have the same emotional weight that it used to carry," she adds. "[You] actually can look at [a memory], think about it, and give yourself a break and acknowledge that it wasn't your fault and forgive yourself," she says.

In a clinical setting (a must — don't try this at home, warns Mitchell), MDMA-assisted therapy has generally involved:

• Preparation: You complete therapy sessions to get ready for the experience and to set intentions, such as processing a specific trauma.

• Medication: You're given MDMA under close supervision of a specifically trained therapy team, who can guide you through a likely range of emotions and redirect your thoughts as needed. This can take up to eight hours.  

• Integration: Over several sessions, therapists help you make sense of insights you may have gleaned while on MDMA and work through any issues that surfaced.

While the treatment is not yet available, it could be up for FDA approval "sometime in the middle of next year," says Mitchell. For the record, MDMA has already been approved for PTSD in Australia.

The potential risks of MDMA-assisted therapy

Possible side effects and risks reflect the importance of taking MDMA for PTSD in a controlled setting, with access to medical care and trained therapists guiding you through the process. Patients and recreational users can experience temporary but potentially dangerous reactions, including nausea, panic attacks, and seizures. With a surge in serotonin and other chemicals can also come a crash once the drug wears off, causing potential mood swings, according to the National Institutes on Drug Abuse (NIDA).

The drug isn't recommended for those with heart problems because it increases heart rate and blood pressure. It's also not best for anyone with a family history or current symptoms of certain psychiatric conditions, including schizophrenia, bipolar disorder, or a personality disorder, as some psychedelics, including MDMA, have been known to trigger psychotic or manic episodes in vulnerable individuals. 

And because you're naturally wondering, addiction to MDMA is possible but less likely than with other drugs such as cocaine. No incidents of "problematic MDMA abuse or dependence" were reported by researchers during the trial, but Mitchell and her co-authors acknowledge that long-term data is needed "to assess the risk of MDMA abuse or misuse after study participation."

theSkimm

MDMA-assisted therapy and its potential to revolutionize PTSD treatment is stirring excitement among some patients and mental health experts. The next stop could be the FDA, but is the world ready to mix party drugs with therapy, or is psychedelic stigma here to stay?