The psychedelic drug MDMA may be an effective treatment for post-traumatic stress disorder, according to a new study. Photo courtesy of The Marines/Flickr
March 22 (UPI) -- The psychedelic drug MDMA, known as "ecstasy" or "molly," is an effective treatment for post-traumatic stress disorder when combined with conventional psychotherapy, a study presented Tuesday during the American Chemical Society spring meeting in San Diego found.
In follow-up data from a phase 3 clinical trial, the psychedelic drug, known formally as 3,4-methylenedioxymethamphetamine, worked even in hard-to-treat patients, such as those with drug or alcohol use disorders, the researchers said.
Forty-two patients with PTSD, treated with MDMA, which is often used illegally as a "club drug" as it increases energy and feelings of pleasure, saw more than 20-point reductions in their change in symptoms, or CAPS-5 scores, the data showed.
CAPS-5 is an 80-point assessment used to measure PTSD symptoms' severity, according to the Department of Veterans Affairs.
In comparison, 37 PTSD patients treated with a placebo, or sham treatment that provides no clinical benefit, had a 14-point improvement on their CAPS-5 scores, the researchers said.
Still, people with PTSD should not try to self-medicate with MDMA, researchers said.
Even "if MDMA is decriminalized, that doesn't mean it's safe," study co-author Jennifer Mitchell said in a press release.
"It can be a very powerful tool, but it needs to have the right dose in the right context with the right support system," said Mitchell, a professor of neurology and psychiatry at the University of California-San Francisco.
PTSD is a debilitating condition that causes amnesia, flashbacks and nightmares related to a traumatic event. People with PTSD have higher risks for depression, anxiety, substance use disorders and suicide, according to the National Institute of Mental Health.
PTSD affects millions of people each year, mostly survivors and witnesses of terrifying or shocking events, such as warfare, assaults or disasters, according to the institute.
Currently available treatments do not work well for everyone, Mitchell said.
For example, anti-depressants called selective serotonin reuptake inhibitors are effective in only about half of patients who take them, she and her colleagues said.
To identify new options, researchers have begun to focus on psychedelic drugs, such as mescaline, psilocin and MDMA for PTSD and other psychiatric disorders, they said.
However, this is hardly new, as some psychiatrists used MDMA to enhance psychotherapy, despite a lack of formal clinical trials or Food and Drug Administration approval, as far back as the 1970s, according to the researchers.
In addition, previous studies have suggested the drug could be an effective treatment for anxiety, as well as PTSD.
"MDMA is really interesting because it's an empathogen," Mitchell said. "It causes the release of oxytocin in the brain, which creates feelings of trust and closeness that can really help in a therapeutic setting."
In addition, animal studies indicate that MDMA, which has been illegal for recreational use in the United States since 1985, can help "reconsolidate," or process, fear memories in an area of the brain called the amygdala, researchers said.
In this study, patients with PTSD treated with MDMA received an 80-milligram dose of the drug, followed by 40 milligrams an hour later.
Participants then attended an eight-hour psychotherapy session after the half-dose.
This process was repeated twice, a month apart each time, in addition to weekly psychotherapy session.
Two months after the final psychotherapy session, about two-thirds of the patients treated with MDMA no longer met the diagnostic criteria for PTSD, compared with one-third of those who received a placebo, the data showed.
Side effects of MDMA, such as jaw-clenching and nausea, were "minimal," and there were no signs of addiction, the researchers said.
Mitchell and her colleagues are enrolling participants for a second phase 3 trial and, if all goes well, they anticipate that MDMA-assisted therapy for PTSD could be approved by the FDA as early as 2023.
"It definitely appears to be equally effective in people who are usually considered treatment resistant," Mitchell said. "People [taking it] ... seemed to have a new perspective on life and engaged more. As their social skill set built up, they were happier over time."