Tuesday, September 21, 2010

Psychiatric Times - Ecstasy Shows Promise as Treatment for PTSD

Another solid research article in support of MDMA (ecstasy) for those suffering from PTSD (post-traumatic stress disorder). This brief review of the recent study comes from Psychiatric Times.

The abstract is posted below, along with the link to the full article, which has been posted as open access. This study was conducted with MAPS, and is the first (?) randomized, controlled pilot-study.

Ecstasy Shows Promise as Treatment for PTSD

September 14, 2010

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

Journal Reference (full text, PDF):

J Psychopharmacol, published online 19 July 2010. DOI: 10.1177/0269881110378371

The safety and efficacy of ±3,4-methylenedioxymethamphetamine-assisted psychotherapy in subjects with chronic, treatment-resistant posttraumatic stress disorder: the first randomized controlled pilot study

Michael C Mithoefer (mmithoefer@mac.com): Private Practice of Psychiatry and Clinical Research, Mount Pleasant SC, USA

Mark T Wagner: Medical University of South Carolina, Charleston SC, USA

Ann T Mithoefer: Private Practice of Psychiatry and Clinical Research, Mount Pleasant SC, USA

Ilsa Jerome: Multidisciplinary Association for Psychedelic Studies, Santa Cruz, CA, USA

Rick Doblin: Multidisciplinary Association for Psychedelic Studies, Santa Cruz, CA, USA

Abstract

Case reports indicate that psychiatrists administered ±3,4-methylenedioxymethamphetamine (MDMA) as a catalyst to psychotherapy before recreational use of MDMA as ‘Ecstasy’ resulted in its criminalization in 1985. Over two decades later, this study is the first completed clinical trial evaluating MDMA as a therapeutic adjunct. Twenty patients with chronic posttraumatic stress disorder, refractory to both psychotherapy and psychopharmacology, were randomly assigned to psychotherapy with concomitant active drug (n = 12) or inactive placebo (n = 8) administered during two 8-h experimental psychotherapy sessions. Both groups received preparatory and follow-up non-drug psychotherapy. The primary outcome measure was the Clinician-Administered PTSD Scale, administered at baseline, 4 days after each experimental session, and 2 months after the second session. Neurocognitive testing, blood pressure, and temperature monitoring were performed. After 2-month follow-up, placebo subjects were offered the option to re-enroll in the experimental procedure with open-label MDMA. Decrease in Clinician-Administered PTSD Scale scores from baseline was significantly greater for the group that received MDMA than for the placebo group at all three time points after baseline. The rate of clinical response was 10/12 (83%) in the active treatment group versus 2/8 (25%) in the placebo group. There were no drug-related serious adverse events, adverse neurocognitive effects or clinically significant blood pressure increases. MDMA-assisted psychotherapy can be administered to posttraumatic stress disorder patients without evidence of harm, and it may be useful in patients refractory to other treatments.


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