The most effective treatment for post-traumatic stress disorder ever since its recognition as a disease entity has been psychotherapy. There have been no medicines that do better in treating PTSD and none that really do a good job in helping treat the condition. Even with prolonged psychotherapy by professionals PTSD remains a chronic condition with significant complications including a high risk of suicide. At No Fallen Heroes we dedicate ourselves to the reduction and elimination of veteran suicide. In this regard we are truly excited about a new aspect of treating post-traumatic stress disorder. The psychedelic medicine success rate treating PTSD is very promising.
Use of Psychedelics for PTSD Treatment
PTSD can be viewed as a wiring problem in the brain. The amygdala is a part of the brain that processes fear, memories of traumatic events, and communicates back and forth with the rest of the brain. When fearful input is repeated again and again it enhances the nerve pathways that go in and out of the amygdala, the wiring, so to speak. Part of the reason that psychotherapy helps is that it helps veterans and others who suffer from PTSD evaluate past events, how they affect the present, and how to put the past in the past where it does not disturb the present. Many with PTSD find it very difficult to do psychotherapy because their feelings are so intense. Psychedelics like MDMA and psilocybin relieve the PTSD sufferer of much of the anxiety associated with their inner experiences.
Success Treating PTSD with Psilocybin and MDMA
The US Food and Drug Administration (FDA) has recommended 2 compounds (MDMA and psilocybin), which are still on the US Drug Enforcement Administration’s most restrictive schedule, as breakthrough therapy prospects for treating PTSD.
The main reason for using MDMA for PTSD is that it reduces the fear response to stimuli that typically provoke fear and anxiety. In the case of PTSD this includes memories of traumatic events. It helps improve introspection and increases interpersonal trust in therapy. This drug does not significantly change awareness or the ability to reason. Thus in therapy a patient can imagine past events and rethink them to put past trauma in the past and decrease the power of current thoughts and events to provoke flashbacks and other PTSD symptoms.
There have been many studies of MDMA in treating PTSD. It is always used as an adjunct to psychotherapy. Results are generally in the range of 90% of those having psychotherapy and MDMA not having any signs of symptoms of PTSD thereafter versus 25% for those who only receive psychotherapy. In general the benefits have been shown to last as long as three to five years! This is why the FDA has given this drug a breakthrough drug designation.
Psilocybin is a classical psychedelic that blocks a specific brain receptor, 5-HT2A. This drug and others was used as an adjunct to psychotherapy in the 1950s and 1960s until psychedelics became scheduled drugs due to widespread misuse. At that point research ground to a halt. It has only been in the last few years that psilocybin has been tried for treatment of PTSD and severe depression. The results of recent studies were sufficiently promising that the drug now has FDA breakthrough drug status. Psilocybin works by depressing the reactivity of the amygdala which allows patients to consider and reimagine past events, putting them in context and taking away their power to control the present.
For those interested in the specifics of these two drugs, MDMA increases release of serotonin, dopamine, norepinephrine, oxytocin, prolactin, vasopressin, and cortisol. It serves as a catalyst to psychotherapy, increases fear extinction, reduces amygdala activity, reopens the critical period for social reward learning, reduces the fear response and shame, increases openness and interpersonal trust, increases emotional empathy, and improves processing of traumatic memories.
Psilocybin is a 5-HT2A receptor agonist, serves as a catalyst to psychotherapy, increases synaptic plasticity, reduces amygdala reactivity during emotional processing, increase insightfulness and introspection, increases divergent thinking and mindfulness-related capacities, cuts back on avoidance, heightens emotional empathy, induces emotional breakthrough experiences and appears to increase access to traumatic memories.
As studies progress, we expect to see these drugs come into common use in treating severe depression post-traumatic stress disorder in veterans thus reducing and eventually eliminating veteran suicide.