Clinical trials investigating the use of MDMA in the treatment of PTSD have led the FDA to categorise it as a 'breakthrough therapy'.
The study, from the The Multidisciplinary Association for Psychedelic Studies and published in the Lancet Psychiatry journal this week, investigated the controlled administration of the drug in conjunction with psychotherapy.
It found that from a sample of 26 veterans and first responders (such as former police officers and fire-fighters), 68 percent of the patient’s symptoms improved to such an extent that they no longer met the clinical criteria for PTSD.
However, the authors did warn that studies are still at a relatively early stage, and were conducted with a small test pool.
A professor in mental defence Studies from King's College London also said that even though the results were interesting, they would unlikely lead to 'fundamental change' in PTSD treatment.
What did the study involve?
The participants were given various doses of the drug between 30mg, 75mg and 125mg. Those given a higher amount experienced significantly less symptoms than those given a lower amount. The doses, which were administered in two 8 hour sessions over a 12 month period, were combined with psychotherapy treatment.
Of participants taking 75mg, 86 per cent no longer met the diagnostic criteria for PTSD. 58 percent of those taking the higher dose, 125mg, no longer met the criteria, meaning it was slightly less effective than the median dose. The lowest dose, 30mg, was the least effective, with 29 percent no longer meeting the PTSD criteria following treatment.
The findings have led the drug to be categorised as a ‘breakthrough’ therapy for PTSD by the US Food and Drug Administration (FDA). It will now move on to further clinical trials.
Previous studies into PTSD have had a high dropout rate as a result of worsening symptoms from therapy that was trauma-related, and also due to a lack of engagement with the therapy.
The authors said the study suggested that effective psychotherapy can be undertaken in conjunction with the drug to accelerate the therapeutic process, as the participants were more engaged with the treatment. The study also reported beneficial changes in personality traits at the 12-month follow up (for example a reduction in neuroticism and an increase in agreeableness and extraversion).
However, the study has several limitations.
The sample size was very small and there was no placebo included.
There were also 85 adverse events reported throughout the study. These included anxiety, headache, fatigue, insomnia and muscle tension.
Some serious events which occurred, including appendicitis, suicidal thoughts and major depression, were not attributed to the drug.
What is MDMA?
MDMA is a class A drug found in ecstasy pills or in powder form. It is used recreationally due to its capacity to induce feelings of euphoria and enhance sensory perception.
Using it carries several considerable health risks, including heart, liver and kidney problems, with many people having severe or fatal reactions to the drug.
According to FRANK, several hundred deaths were recorded between 1996 and 2014 In England and Wales where ecstasy or MDMA was a factor on the death certificate, and long-term use has also been linked with memory and mental health problems.
It is illegal in the UK, carrying a maximum prison sentence of 7 years for possession.
What is PTSD and how is it treated?
PTSD is a mental health condition that can develop after experiencing or witnessing a traumatic event, such as a natural disaster, sexual assault, or during combat.
Symptoms of PTSD can include:
- reliving the event (this can happen through nightmares or flashbacks)
- attempting to avoid anything that may trigger traumatic memories
- having generally more negative thoughts (shame or guilt from the event)
- and hyperarousal (being always always alert and having feelings of paranoia).
PTSD is usually treated with psychotherapy. This is done with the help of a therapist to delve into the issues surrounding the event and help to discuss the feelings and thoughts that someone may have.
There are several different types of psychotherapy used to treat PTSD:
- Cognitive Processing Therapy: This is aligning beliefs and thoughts to behaviour and feelings; it teaches the brain skills to help someone deal with stressful situations
- Prolonged Exposure: This is where the patient talks about the trauma repeatedly until the memories are no longer upsetting.
- Eye Movement Desensitization and Reprocessing: This involves focusing on sounds or hand movements whilst talking about the event. It helps the brain to process the memories with the help of added stimuli.
What do the results mean?
Promising as they may seem, it isn’t really possible to draw any concrete conclusions from these results at present. Further studies are required to determine whether or not this is a form of treatment that could ever feasibly be used in clinical practice.
Dr Neil Greenberg, a professor specialising in defence mental health at King's College London, noted that while the results did make for interesting reading, due to the small size of the study pool and the high risk of side effects, they were unlikely to have any 'fundamental change' on the services available for PTSD.
It’s also important to note that this study was undertaken in controlled settings, under close supervision from clinical experts. For now, MDMA remains a prohibited substance. Taking it, recreationally or medicinally, can obviously be very dangerous.
If you think you may be experiencing PTSD, speak to your GP. They will be able to offer support, or refer you to a specialist for therapy where needed.