Ecstasy isn’t just for club kids: It may also be just what the doctor will soon be prescribing to veterans and others suffering from PTSD, technically Post Traumatic Stress Disorder.
A new Cureus Journal of Medical Science review delivers promising suggestions for the future of PTSD treatment. The review surveyed trials in which MDMA — commonly known as “molly” or “ecstasy”– was used alongside psychotherapy to reframe memories associated with fear or pain in PTSD patients.
“The combined neurobiological effects of MDMA increase compassion and reduce defenses and fear of emotional injury while enhancing communication and introspection,” the researchers wrote. “MDMA may allow for the reprocessing of traumatic memories and increase emotional engagement with therapeutic processes, thereby assisting with the psychotherapeutic treatment of PTSD.”
MDMA triggers the release of neurotransmitters — such as dopamine, serotonin and norepinephrine — which bring about a heightened sensory experience, euphoria, enhanced energy and distortion of time, among other things. The review found the use of MDMA with psychotherapy increased therapeutic success and decreased treatment dropout rates, which are around 24% among the less-than-half of PTSD patients who do seek treatment.
PTSD falls into the treatment-resistant psychiatric disorder category, or those that often require various trials of drug combinations, dosages and uses before finding any that help. Thus they’re difficult to treat. When compared to data for the only two Food and Drug Administration-approved oral medications for PTSD, MDMA had between two and three times the efficacy.
Prediction error is an important psychological phenomenon for destabilizing traumatic memories; it refers to a mismatch between what the brain expects to happen and what actually happens. Because dopamine is a part of the brain’s positive reinforcement system, recalling traumatic memories under the influence of MDMA can lead to prediction error.
“This mismatch of experiences, such as recall of memory with strong fear/anxiety versus recall with emotions such as love or empathy, would allow for an update of the information through molecular mechanisms,” the review states.
This process is a part of memory reconsolidation — or modifying an established memory through reactivation and destabilization — which helps disarm the crippling effects of trauma. As MDMA metabolizes in the body it also interacts with the brain’s receptors in a way “which could contribute to a change in the perception of pain and in the regulation of behavior, including impulsive behavior,” according to the review.
Despite having long been stigmatized as “dangerous and messy,” controlled usage and dosages of the synthetic drug could have profoundly positive effects on an incredibly stubborn psychiatric disorder, the review suggests.
“In conclusion, our work suggests that MDMA-assisted psychotherapy is a safe, effective and durable treatment for individuals with PTSD,” the researchers wrote. “Phase 3 clinical trials are near completion, which will serve to increase the validity of this evidence.”