MDMA & PTSD: A Comprehensive Review

There aren’t many therapy choices for a number of mental health illnesses, including Post-Traumatic Stress Disorders (PTSD). Methylenedioxymethamphetamine (MDMA), which may help individuals with these conditions regain function, has recently attracted considerable attention. The main theory is that MDMA enhances patients’ capacity to treat the disorder’s underlying psychopathology through prosocial effects.

What is MDMA?

Methylenedioxymethamphetamine, often known as MDMA, is an amphetamine derivative and a substance from the phenethylamine family of drugs that can have stimulant, hallucinogen, and/or entactogenic effects. It results in an invigorating impact, temporal and perceptional distortions, and increased appreciation of sensory stimuli. It has also been called an entactogen, a substance that raises empathy and self-awareness.

Pharmacology of methylenedioxymethamphetamine (MDMA)

The blood-brain barrier is crossed by MDMA, which also interacts with a number of brain receptors. However, the serotonin transporter has the strongest affinity, followed by the norepinephrine and dopamine transporters.

A substantial elevation and increase in extracellular dopamine and norepinephrine are the main effects of acute MDMA consumption. The majority of MDMA’s behavioural effects have been linked to changes in these neuro-chemical responses, but the drug also stimulates the production of other hormones, including oxytocin, which may also contribute to some of these effects.

Following MDMA use, common effects include:

• Better feeling of wellbeing
• Higher extroversion
• Warmth of the heart Empathy for others and for oneself
• Willingness to talk about memories that are emotionally charged
• Increased sensory awareness

A Brief Overview of MDMA in Psychiatry

Since the beginning of the 20th century, psychedelics have been investigated as potential supplements to psychotherapy. The fundamental rationale for using these medications was that they would aid in the patient’s awareness of repressed feelings and desires, making them susceptible to intervention through conventional therapeutic techniques.

A change in the scheduling of psychedelics resulted from widespread illicit usage and worries about potential risk, which essentially put an end to further experimentation for several decades.

• In spite of the fact that it had not undergone rigorous clinical studies or been given FDA approval for use in humans, MDMA developed a small following among psychiatrists in the late 1970s and early 1980s. Some psychiatrists thought it improved patient-doctor interaction and helped patients gain new perspectives on their issues. Additionally, MDMA started to become more commonly accessible on the streets about this period.

Methylenedioxymethamphetamine (MDMA), like the earlier psychedelics, was first suggested as a supplement to psychotherapy, but due to worries about abuse potential and a variety of potential side effects, MDMA was classified as a Schedule 1 controlled substance under the United Nations Convention on Psychotropic Substances in the majority of countries.

• Drugs with a high potential for misuse and no currently recognized medical utility in therapy are included in this schedule. Recently, MDMA has been proposed as a viable treatment for some addiction and mental health conditions.

However, recent research has indicated that MDMA may be useful as a supplement to conventional psychotherapy in the treatment of post-traumatic stress disorder (PTSD), and the Food and Drug Administration has granted authorization for a comprehensive phase 3 clinical trial.

Drugs with a high potential for misuse and no currently recognized medical utility in therapy are included in this schedule. Recently, MDMA has been proposed as a viable treatment for some addiction and mental health conditions.

However, recent research has indicated that MDMA may be useful as a supplement to conventional psychotherapy in the treatment of post-traumatic stress disorder (PTSD), and the Food and Drug Administration has granted authorization for a comprehensive phase 3 clinical trial.

What is PTSD?

The emotional distress that follows an event involving actual or threatened death, serious injury, or a threat to physical integrity is known as PTSD. This disorder is classified as a type of trauma and stressor-related disorder and is characterized by persistent symptoms of elevated sympathetic nervous system arousal.

MDMA as Possible Adjunct Treatment for PTSD?

It has been demonstrated that MDMA increases social connections, reduces negative reactions to social rejection and negative facial expressions, and fosters prosocial and cooperative behaviour.

• Due to the ability to relive painful memories without experiencing the intensely negative emotions that have historically led to high rates of patient dropout, it has lately been proposed as a helpful addition to therapy for the treatment of PTSD. There is evidence to suggest that MDMA may work well as a PTSD treatment adjunct.

The range of diseases that might be predicted to benefit from MDMA-assisted psychotherapy has recently been broadened to include generalized anxiety disorders; impairments in social functioning, particularly those related to interpersonal relationships; and post-traumatic stress disorder (PTSD).

There have been a few studies to evaluate the efficacy of MDMA in PTSD that were randomized, placebo-controlled, double-blind, and financed by the Multidisciplinary Association for Psychedelic Studies. Only 2 trials with participants who fulfilled the DSM-IVR criteria for PTSD were randomized and placebo-controlled, according to a meta-analysis. In both investigations, MDMA was found to have positive effects.

According to one study, MDMA may be used in conjunction with psychotherapy to treat PTSD because it seems to lessen the fear response and reduce defensiveness without obstructing access to memories.

• MDMA may also make it easier to participate in therapy by fostering the therapeutic alliance and improving the ability to recognize and respond to emotional states. It is possible for people to remain emotionally invested in traumatic experiences without becoming overpowered by anxiety or other unpleasant emotions, avoiding them by dissociating from them, or becoming emotionally numb.

A more recent randomized, double-blind dose-response trial investigated the effects of MDMA on a population of treatment-resistant veterans, firefighters, or police officers, who also received psychotherapy, and who were largely male (73%) participants.

• Five years were spent doing the study. The 26 participants were randomized to receive 1 of 3 dosages of MDMA (30, 75, or 125 mg). In a crossover design, further 125-mg doses of MDMA were given. In this small sample, the higher dosages of MDMA resulted in appreciable PTSD benefits that lasted at least a year.

These preliminary results are positive and support the notion that MDMA might be a useful addition to more conventional psychotherapy, as MDMA-assisted psychotherapy may benefit those who have gone through psychological trauma but have not been able to recover on their own.

Summation

In conclusion, MDMA-assisted psychotherapy is a potential strategy for assisting patients who have gone through psychological trauma and have not been able to find relief from the problems that resulted through traditional therapeutic alternatives. Its effectiveness, safety, and long-term advantages are still being studied.

We must not let assumptions, politics, puritanism, or ignorance stand in the way of integrating an exciting new holistic approach to psychopathology because MDMA may be able to bridge the gap between psychotherapy and psychopharmacology.