More Evidence That MDMA Could Ease PTSD

Originally appearing here. British doctors want to repeat the findings of an American study that shows MDMA — the active drug in ecstasy — to be hugely helpful in treating post-traumatic stress disorder. The idea is not quite to hand combat veterans tabs of “E” for a night of clubbing, but the researchers do think a number of currently illegal drugs, like LSD or magic mushrooms, could help trauma-damaged brains. “I feel quite strongly that many drugs with therapeutic potential have been denied to patients and researchers because of the drugs’ regulation,” Dr. David Nutt, a controversial psychopharmacologist in Britain, told the Guardian newspaper. “The drugs have been made illegal in a vain attempt to stop kids using them, but people haven’t thought about the negative consequences.” U.S. researchers in South Carolina tested 20 people suffering mostly from childhood trauma, who received a combination of the drug and psychotherapy. A control group received a placebo, but 83 percent of the patients dosed with MDMA (10 of 12) were cured in two months. That compares astonishingly well with 24 percent of the control group. “I expected it was going to be effective,” said Michael Mithoefer, the South Carolina psychiatrist who announced these results in 2010. “But I didn’t necessarily expect we’d find such statistical significance in that number [of people]. That was the icing on the cake.” Mithoefer ran the study with his wife, Ann. The most obvious shortcoming of their early trial is that 20 people just isn’t a large sample. So the research has moved into a new trial phase. Nineteen of Mithoefer’s original patients were child-abuse victims who had suffered PTSD symptoms for around 20 years; only one was a combat veteran. But those who responded to MDMA saw their symptoms vanish completely during the eight-week study. All had been diagnosed with severe PTSD, and had received more conventional treatments and drugs. These findings add lots of meat to the bones of two Norwegian researchers, Pål-Ørjan Johansen and Teri Krebs, profiled by Miller-McCune just two years ago, who called for more investigation of what they called “exposure therapy.” “People with PTSD often avoid triggers or reminders of the trauma and feel emotionally disconnected or are unable to benefit from the support of others — likely contributing to the development and maintenance of the disorder.” They told Miller-McCune’s Matt Palmquist. “A goal during exposure therapy for PTSD is to recall distressing experiences while at the same time remaining grounded in the present.” Which echoes the observations of Mithoefer: “Interestingly, several people said after their session: ‘I don’t know why they call this ecstasy’ — because it was not an ecstatic experience. They were revisiting the trauma. It was very difficult and painful work, but the ecstasy gave them the feeling they could do it.” Specifically, it reduced their fear of remembering traumatic events in therapy and facing floods of emotion. “What’s most comforting is knowing now I can handle difficult feelings without being overwhelmed,” said one patient, according to the Guardian. “I realize feeling the fear and anger is not nearly as big a deal as I thought it would be.” Mithoefer plans to repeat his own study on patients who fought in America’s recent wars, to see if the results hold up for combat stress. In Britain, David Nutt and his colleague Ben Sessa want to run a similar trial but with “lots of neuroimaging.” So far researchers have made very few brain scans of people under the influence of MDMA, precisely because the drug is illegal. But the surprising results and the recent new demand for PTSD treatment in Britain and the United States could open a new chapter in the clinical study of hallucinogens, which Western governments criminalized only after a war on drugs gained momentum in the ’60s and ’70s. Nutt had headed the United Kingdom government’s Advisory Council on the Misuse of Drugs, but Gordon Brown’s health minister sacked him at the end of 2009 for objecting in public to stricter laws against marijuana. British law has three categories of severity for illicit drugs, which the courts use as guidelines to punish users. The government had recently re-classified pot. “The obscenity of hunting down low-level cannabis users to protect them is beyond absurd,” said Nutt, who was then labeled “the nutty professor” by some British tabloids. Britain’s home secretary, Alan Johnson, suffered a backlash after the controversy because the public tended to agree with Nutt that both cannabis and ecstasy were less harmful than cigarettes or alcohol. European Dispatch explains how MAPS’ possible UK study of MDMA-assisted psychotherapy for PTSD will build on the outstanding results of our flagship U.S. study. If we can find the funding necessary for this study, it will be the first-ever clinical trial of MDMA in the UK and the latest addition to our expanding international MDMA-assisted psychotherapy research program.