Post-traumatic stress disorder, or PTSD, is notoriously difficult to treat. In the U.S., around six out of every 100 people will develop PTSD at some point in their lives, and while the cornerstone of treatment, called cognitive processing or “talk” therapy, offers some relief, it doesn’t work for around 50 percent of patients.
However, in recent years, with the renewed interest in psychedelics, illicit substances like 3,4-methylenedioxymethamphetamine, better known as MDMA, may provide an effective therapeutic answer. In a study published late last week in the journal Nature, a randomized clinical trial where participants with PTSD were given either MDMA or a placebo paired with talk therapy experienced a significant reduction in and even eventual resolution of their symptoms when incorporating the psychedelic.
This isn’t the first study of its nature to show promise for the infamous party drug. Its therapeutic origins date back to the mid-1970s when medicinal chemist Alexander Shulgin introduced MDMA as a possible mental health treatment. Its place in psychotherapy was cut short by the U.S. Drug Enforcement Administration identifying and criminalizing the compound as a drug of abuse in the mid-1980s.
A decade later, the Multidisciplinary Association for Psychedelic Studies (MAPS) pioneered clinical trials investigating MDMA-assisted psychotherapy for PTSD treatment. Studies since then have shown the drug capable of helping those with PTSD better contend with their negative emotions, encouraging prosocial feelings by influencing neurochemicals serotonin and dopamine, and decreasing activity in parts of the brain associated with fear.
In the new Nature paper, around 104 participants who were diagnosed with moderate to severe PTSD and had been living with the condition for an average of 16 years received a variety of talk therapy sessions, one of which included an eight-hour experimental session where 53 participants received MDMA and the rest a placebo. The clinical trial consisted of three treatment sessions spaced one month apart.
By the end of the study, the researchers found that nearly 87 percent of patients who got MDMA experienced a significant dip in PTSD symptom severity at 18 weeks after their baseline assessment compared to 69 percent in the placebo group. Furthermore, among that group, approximately 71 percent demonstrated so much improvement that they no longer met the criteria for PTSD diagnosis compared to 48 percent in the placebo group.
The researchers’ next step is to see whether MDMA’s benefits are durable over the long term. Findings from a 2020 study sponsored by MAPS suggest they might be by up to 12 months.
As the therapeutic potential of psychedelics gains increasing buy-in from health professionals and lawmakers across the U.S., MDMA could be approved as early as 2024. According to a statement by the Department of Health and Human Services from July 2022, the FDA anticipates approving the drug for psychedelic-assisted therapy within 24 months. The FDA already granted the drug “breakthrough therapy” status in August 2017, which made it possible for researchers to study it in clinical trials. Currently, Australia is the only other country to approve MDMA for psychiatric conditions, which occurred this past June.
