A Cure for PTSD?

Ishika Sonal

Post-Traumatic Stress Disorder refers to an anxiety disorder generally characterised by flashbacks, nightmares, avoidant behaviour, and severe prevalent anxiety post experiencing or witnessing a traumatic event. On the other hand, MDMA is a drug most commonly associated and classified with other drugs such as ecstasy, and is currently classified as a Schedule 1 drug under the Controlled Substances Act of the United States. This labels it as a substance with a high potential for abuse and addiction, with no beneficial uses. However, despite this classification, the beneficial effects of MDMA were actually studied in clinical settings in the 1970s, and evidence proved contrary to what its current legal standing implies. (Pentney, A.R. (2001) An exploration of the history and controversies surrounding MDMA and MDA.Journal of Psychoactive Drugs. 213-21.)

While research into the exact effects of MDMA on the brain are still ongoing, restricted by both the government and its laws, as well as by the debatable ethics behind administering a drug with the potential for both abuse and addiction, the drug has been found to increase chemicals such as serotonin and oxytocin, as well as reducing activity in the amygdala, the part of the brain that processes fear. This in turn leads to heightened states of safety and feelings of social connection. (Stone, W. (2001, August 21. MDMA, or Ecstasy, Shows Promise as a PTSD Treatment. Retrieved from https://www.scientificamerican.com/article/ mdma-or-ecstasy-shows-promise-as-a-ptsd-treatment/) These affects of MDMA on the brain are currently being explored by certain organisations as a treatment for PTSD, a disorder that has not seen the emergence of a new drug in over 17 years.

Research trials conducted by the Multidisciplinary Association of Psychedelic Studies (MAPS) concluded that MDMA ‘reduced fear and defensiveness, as well as enhanced communication, introspection, empathy, and compassion. This in turn resulted in an enhanced therapeutic experience for individuals suffering from PTSD.’ (Multidisciplinary Association for Psychedelic studies, 2017)

In 2017, the FDA designated a study being carried out by MAPS as a ‘Breakthrough Therapy’. (Stone, 2019) MAPS is a ‘non-profit research and educational organisation’ and conducts intensive clinical experiments and research in multiple fields, currently most primarily focusing on ‘sponsoring FDA drug development research into MDMA-assisted psychotherapy for the treatment of PTSD.’ (Multidisciplinary Association for Psychedelic studies, 2017)

This experimental setup is currently in Phase III of its clinical trials, which is the final phase of clinical trials that the FDA would require prior to determining the possibility of approving MDMA as a prescription drug for treating PTSD. Phase III consists of ‘randomised, double-blind, placebo-controlled, multi site clinical trials aiming to assess the safety and efficiency of MDMA-assisted psychotherapy in 200-300 patients with severe PTSD.’ (Multidisciplinary Association, 2019)

Personal accounts taken from individuals who participated in the FDA approved study being carried out by MAPS concludes that the participants were able to revisit the traumatic events in the absence of the usual anxiety, panic, and terror under the effects of MDMA. The MDMA is prescribed over 3 sessions, and patients are then guided through it by specially trained therapists, who follow the session with intensive talk therapy aimed around the contents of what was said and experienced while under the influence of MDMA. The entire treatment plan lasts 12 weeks. (Stone, W. (2001, August 21. MDMA, or Ecstasy, Shows Promise as a PTSD Treatment. Retrieved from https://www.scientificamerican.com/article/mdma-or-ecstasy-shows-promise-as- a-ptsd-treatment/)
Not only were participants able to openly talk about their anxious thoughts and feelings stemming from PTSD, some were even able to access more joyful memories that had been suppressed.
In fact, 2 months post the Phase 2 trials, 61% of the 107 participants suffering from chronic PTSD (for an average time period of 17.8 years across them), no longer qualified to be diagnosed as such. Following up after 12 months, 68% of participants were found to be no longer suffering from PTSD. (Stone, W. (2001, August 21. MDMA, or Ecstasy, Shows Promise as a PTSD Treatment. Retrieved from https:// www.scientificamerican.com/article/mdma-or-ecstasy-shows-promise-as-a-ptsd-treatment/)

While recognising the potential this drugs offers in association with psychotherapy is certainly a much needed breakthrough, regardless one cannot argue against the fact that PTSD and Substance Abuse Disorders (SUDs) frequently co-occur. (McCauley, J.L. (2012) Posttraumatic Stress Disorder and Co-occuring Substance Abuse Disorders. Clin Psychol, (19(3)). 10.1111/cpsp.12006) Thus one must certainly account for the high potential of abuse, addiction, as well as stigma that would accompany the prescribing of MDMA even if carried out by trained professionals and accompanied by psychotherapy. While these two points of view regarding this research study may seem to contradict, they are too closely entwined for one to address only a single side of the argument.

References:

Pentney, A.R. (2001) An exploration of the history and controversies surrounding MDMA and MDA.
Journal of Psychoactive Drugs. 213-21.

Stone, W. (2001, August 21. MDMA, or Ecstasy, Shows Promise as a PTSD Treatment. Retrieved from
https://www.scientificamerican.com/article/mdma-or-ecstasy-shows-promise-as-a-ptsd-treatment/ Multidisciplinary Association for Psychedelic studies, 2017

McCauley, J.L. (2012) Posttraumatic Stress Disorder and Co-occuring Substance Abuse Disorders. Clin Psychol, (19(3)). 10.1111/cpsp.12006