Ecstasy Shows Promise as Treatment for PTSD
Ecstasy Shows Promise as Treatment for PTSD
Results from a study published in the Journal of Psychopharmacology suggest that 3,4-methylenedioxymethamphetamine (MDMA) combined with psychotherapy may be a safe and effective treatment for symptoms of post-traumatic stress disorder. Widely known as the recreational (and illegal) drug, ecstasy, MDMA has been reported to decrease feelings of fear while maintaining a clear-headed alert state of consciousness.1
In this phase 2 clinical study, Dr Mithoefer and colleagues randomized 20 treatment-resistant patients who had chronic PTSD to either active treatment (MDMA) or placebo during two 8-hour psychotherapy sessions. The Clinician-Administered PTSD Scale (CAPS) was used to measure primary outcomes. The CAPS was administered at baseline, 4 days after each session, and 2 months after the second session. Reductions in CAPS scores were significantly greater in the group who had received the MDMA compared with the placebo group at all 3 post-baseline time points.
The promising results of this study warrant further exploration of MDMA as a therapeutic adjunct for the treatment of PTSD.
1. Greer GR, Tolbert R. A method of conducting therapeutic sessions with MDMA. J Psychoactive Drugs. 1998;30:371-379.
Related content:
Assessment and Diagnosis of Post-Traumatic Stress Disorder
PTSD Is a Valid Diagnosis: Who Benefits From Challenging Its Existence?
MDMA and Ecstasy
For a discussion of the adverse effects of MDMA, see "Ecstasy: Nothing for Aging Adults to Rave About" by Dr Gregory Rutecki. --Julie Bowen, Editor, Consultant
Psychiatric Times received the following response from the authors regarding Dr LaMar's comment:
We agree with Dr. LaMar that there are certainly "ways to heal and create a life without…using Ecstasy". There are a number of valuable treatments for PTSD that are effective for many people, but still, millions of others are not adequately treated and continue to suffer. In our pilot study, people who had not responded to other forms of therapy, including recognized medications and psychotherapy, showed very significant response to MDMA-assisted therapy. Dr. LaMar does not specify what her concerns are, but it is understandable that she would be concerned if she has the misunderstanding that MDMA simply "enhances mood and takes a person out of reality". This is not the effect we observed. As we describe in our paper, what we did observe is that MDMA helped people face the reality of their trauma and process its effects while staying emotionally engaged without becoming overwhelmed by anxiety. MDMA thereby appeared to contribute to overcoming the well known obstacles to treatment referred to as "underengagement"or "overengagement" (Foa et al. 2009). And, although at times most participants had some positive, affirming experiences (which generally provided a more realistic perspective about reality than the cognitive distortions that often accompany PTSD), it was not simply a matter of "enhanced mood." Several of our study participants said things like, "I don't know why they call this ecstasy", because as with most methods of therapy, facing their trauma was challenging and often painful, and for most of them, ultimately very helpful.
Our paper is not advocating the use of MDMA for treatment. It is reporting on a scientific study that sought empirical evidence to test a novel research hypothesis regarding the possible risks and benefits of the therapeutic use of MDMA. What we conclude is that these results are promising and additional well designed rigorous research is called for.
We would like to refer Dr. Lamar to our full text article that is available without charge from the publisher's website
(http://jop.sagepub.com/content/early/recent, July 19,2010) and our draft Treatment Manual that describes the treatment in detail at http://www.maps.org/research/treatment_manual_9_15_2010.pdf.
Michael C. Mithoefer, M.D.
Mark T. Wagner, Ph.D.
Ann T. Mithoefer, B.S.N.
Lisa Jerome, Ph.D.
Rick Doblin, Ph.D.
I have heard of this research before and am concerned about the use of ecstasy in treating anyone, let alone our vets with PTSD. Of course ecstasy works; it's a drug to enhance mood and take a person out of reality. I have been a psychologist for over thirty years and specialize in treatment of abuse, neglect and traumas. There are ways to heal and create a life without the pain and without using ecstasy. I encourage everyone with PTSD to get the help they need to heal, not mask the problems and pain.