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MDMA (Ecstasy) in the treatment of posttraumatic stress disorder (PTSD) : a clinical plan

I can’t decide if this seems like a load of hippie bullshit or like there might be actual science involved here (or something between). If I weren’t so goddamned anhedonic lately, maybe I could trust myself to make such distinctions with any level of competence. Right now though, even the alphabet seems full of suspicious mush.

Snip…

So, while my education is pretty intensely non-practical, one of my few skills is reading medical literature.

The abstract links to an article from 2002 which describes a plan for building evidence for the regular use of MDMA in the treatment of PTSD. They propose a few different studies, two of which had basically been set up, recruited, and were either under way or about to start (the rest of the studies would happen or not based on the results of these other studies, presumably).

The first study they proposed was very small, 6 women who in Spain who had been sexually assaulted and had chronic PTSD that was resistant to other treatments. Four of the women received MDMA, 2 received a placebo. The results from that study were published in September of last year (about 6 years after the study had finished), and they seem to be pretty positive. They use a number of psychological assessments, none of which I’m familiar with, but in all of them a lower score is better, and the subjects who were given MDMA show lower scores on most of the assessments after treatment, while the placebo treated women don’t. I had some questions about the follow-up (which was kind of spotty), but it turns out the study was halted after pressure from the Spanish Anti-Drug Authority. The small sample size here makes the results impossible to really extrapolate, but I’d call the results “promising, but not definitive”.

The second study seems to be underway right now, with the data having been collected, so maybe there’ll be something published on this in the next six months or so. There are also larger studies as described in that article which are recruiting now, one in Israel and one in Switzerland (which I’m guessing was originally planned for the US but they couldn’t get it approved or decided it would be easier somewhere else).

There’s definitely evidence that MDMA is, in therapeutic doses (which are lower than recreational doses) and administered only a few times (which is what the author of the linked abstract is suggesting) is safe. The effectiveness question is unsettled, but the initial results are interesting, and I really hope that the remaining studies help clarify it.

So I guess my overall assessment is that this looks like sound science, but it’s too early to tell if it really works. There’s also a question in my mind about real-world treatment protocols. There’s a lot more to this that tossing the drug at the patients and leaving it at that. These studies are of giving MDMA to someone and conducting a full day of therapy, then repeating that 2 or 3 times over several months. Would specialized training be required for the therapists? How dependent is the efficacy on the course and content of the therapy? OK, that’s enough out of me.

Source: vmarinelli