How ecstasy could help soldiers and sex assault victims treat their PTSD
The illegal party drug MDMA used in ecstasy pills may also help witnesses shocked by disasters, serious accidents and physical or sexual attacks, scientists said.
Ecstasy could soon be given to soldiers and sex assault victims to treat their PTSD, according to new research.
The illegal party drug MDMA used in ecstasy pills may also help witnesses shocked by disasters, serious accidents and physical or sexual attacks, scientists said.
In the United States, possession of MDMA is illegal.
The class A dance drug is blamed for the deaths of hundreds of mainly young people from seizures and high blood pressure.
Now it is set to be prescribed to mentally disturbed patients in the US - from next year, while King's College London is carrying out British trials.
General Sir Nick Carter, former chief of the armed forces, previously said ecstasy could "make a critical difference" to veterans suffering from anxiety disorders caused by combat.
Post-traumatic stress disorder (PTSD) affects millions each year - triggering amnesia, flashbacks and nightmares.
A course of MDMA, or 'ecstasy', rid two in three study participants of symptoms - in weeks.
Principal investigator Professor Jennifer Mitchell, of the University of California, San Francisco, said: "MDMA is really interesting because it is an empathogen.
"It causes the release of oxytocin in the brain, which creates feelings of trust and closeness that can really help in a therapeutic setting."
Animal experiments have also shown ecstasy boosts the processing of fear memories in an area of the brain called the amygdala.
Combined with counseling, it worked even in hard-to-treat patients with drink or drug problems. Ecstasy increased its effectiveness.
Patients with PTSD have higher risks of depression, anxiety, substance use disorders and suicide.
Antidepressants called SSRIs (selective serotonin reuptake inhibitors) work in only about half. Many fail to respond or quit psychotherapy, researchers said.
The phase 3 trial involved 90 people with severe PTSD - half of whom were assigned at random to receive ecstasy.
They attended an eight-hour therapy session after a small dose with the process repeated twice over a month - in addition to weekly therapy.
Two months after the final session, about two-thirds of those given ecstasy no longer met the diagnostic criteria for PTSD.
This was compared with a third of those who received a dummy pill plus counseling.
Side effects such as jaw clenching and nausea were minimal - and there were no signs of addiction.
Prof Mitchell added: "The effect size for MDMA-assisted therapy is better than that for the SSRIs that have been investigated - suggesting MDMA is a far better therapeutic for PTSD."
Participants are now being enrolled for a second phase 3 trial. If all goes well, ecstasy for PTSD could be approved by the US Food and Drug Administration (FDA) next year.
The researchers also recently completed a study showing the drug is effective in people resistant to traditional PTSD treatment - such as those with drug or alcohol use disorders.
Prof Mitchell said: "It definitely appears to be equally effective in people who are usually considered treatment-resistant.
"So we are very excited to think that MDMA-assisted therapy is going to be an effective therapeutic in that hard-to-reach population."
To find out how long the treatment might last, the researchers are now analyzing long-term data from the phase 3 trial.
Prof Mitchell said: "People in the phase 2 trial were better for years. They seemed to have a new perspective on life and engaged more. As their social skill set built up, they were happier over time."
But people in the phase 3 trial had more severe symptoms - so their treatment might not be as durable.
Gen Carter, who retired in November as Chief of Defence Staff, is patron of UK charity Supporting Wounded Veterans.
He says existing treatments for PTSD are limited and believes ecstasy may provide the solution.
Dr James Rucker, a consultant psychiatrist at King's, says evidence suggests tit works by quietening the fight or flight system in the brain - which is over-active in cases of PTSD.
Despite the promising preliminary results, people with PTSD should not try to self-medicate with ecstasy.
Added Prof Mitchell: "If MDMA is decriminalized, that doesn't mean it is safe.
"It can be a very powerful tool, but it needs to have the right dose in the right context with the right support system."
Recently, there's been a surge in interest and research on the use of psychedelic drugs such as mescaline, psilocin and ecstasy for the treatment of psychiatric disorders.
But the idea such compounds could enhance psychotherapy isn’t new, says Prof Mitchell.
Beginning in the 1970s, some psychiatrists used ecstasy to enhance psychotherapy - despite a lack of formal clinical trials or FDA approval.
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