Long-awaited approval of MDMA for treatment of PTSD may be just around the corner. The psychedelic medicine, MDMA, has passed another controlled trial for treatment of individuals with post-traumatic stress disorder. This is important because the US Food and Drug Administration requires at least two placebo-controlled trials of a medicine before allowing its use for prescribed therapy outside of a research setting. Not only did MDMA do well in this study but it did better than in a study published in 2021. The Multidisciplinary Association for Psychedelic Studies (MAPS), which sponsored the study, intends to make their case for approval of MDMA to the FDA with the expectation of getting approval in 2024.
What Did the MDMA Study Tell Us?
The controlled study of MDMA consisted of a comparison of talk therapy for PTSD with MDMA-assisted talk therapy. All test subjects had diagnoses of PTSD. Previous research showed that 62% of those receiving MDMA no longer fit the criteria for PTSD after treatment versus 32% for talk therapy alone. However, there was a high dropout rate in the placebo group. In the current study 71% of those receiving MDMA no longer had PTSD compared to 48% who just got talk therapy. A big difference was that in the current study MDMA worked as well in people who had other mental health issues like depression along with PTSD and in people who had extremely long histories of PTSD. It also did equally well in all ethnic groups studied.
Why Does MDMA Help Treat PTSD?
Something that we have emphasized in prior articles is that just taking MDMA is not enough to help treat PTSD. The setting is critical. MDMA and other psychedelics make it much easier for persons suffering from PTSD, depression, substance abuse disorders and other conditions to recall and deal with their past. Thus, their function is to make coaching, talk therapy, or psychotherapy much more effective The researchers in the current study refer to MDMA as a “communication lubricant.” They cite the low dropout rate in the current study of 9% which involved mostly those who received a placebo and not MDMA. Those who received the real medicine got results and got them quickly enough that they stayed the course and finished therapy.
MDMA Induces Self-compassion
In life we are often too hard on ourselves. This is especially true with those for whom discipline is an important part of what they do. Thus is especially applies to those in the military and the same folks when they are retired veterans. It is all too common for a veteran to blame themself for not doing enough in a traumatic situation. The same person would probably tell a comrade that they need to let up a bit and give themselves a break. What MDMA appears to do is help someone who after years and years is still being too hard on themselves the internal permission to give themselves a break! MDMA does not make the therapeutic experience “fun” say the researchers. But it does make therapy more effective.
How Many Treatment Sessions to Make PTSD Better?
Something that stood out when we looked at this study was that people only had three treatment sessions instead of a dozen. Previous research has typically involved a lot more than just three sessions. As a practical matter, treatment with psychedelics like MDMA can be expensive. The biggest part of the expense is all of the therapy sessions required. If the current study is to be believed, no more than three sessions are needed to many if not most people to successfully treat PTSD. This includes those who have been suffering from PTSD for years and years.
What Happens When the FDA OKs MDMA?
The best guess seems to be that MDMA will pass the FDA in 2024. This does not mean that you will be able to go to the corner pharmacy to get a packet of MDMA for your PTSD under your doctor’s prescription. In all likelihood the US will follow the example of Australia. MDMA will be OK’d to use along with psychotherapy by professionals who have appropriate training and experience. Because the current study showed that talk therapy alone is enough for about half of patients with PTSD, MDMA may well be reserved for those who fail psychotherapy alone.
