MDMA-Assisted Therapy for PTSD: What to Know

What Is MDMA-Assisted Therapy for PTSD?

MDMA, more popularly known as ecstasy or Molly, is a psychoactive drug that acts as stimulant and releases chemicals in your brain to give an energizing effect, heighten your senses, and boost emotions like self-awareness and empathy.

Experts are tapping into MDMA’s effects as part of therapy for severe posttraumatic stress disorder (PTSD), a mental health condition that affects nearly 3.5% of U.S. adults.

How Can MDMA Help?

PTSD happens after someone goes through a traumatic event like a serious accident, sexual abuse, injuries, or war. Memories may pop up as flashbacks or nightmares and force some people to relive terrifying moments. Severe PTSD can also lead to suicide.

There’s no medication to treat PTSD itself, but some medicines may ease symptoms. Treatments like talk therapy and cognitive behavioral therapy can also help. But almost a third of people drop out of therapy, and up to 58% still have PTSD symptoms after they finish. This is where MDMA comes in.

Experts have found that when people with PTSD are given a certain amount of MDMA in a clinical setting, it helps them open up so they can work through traumatic events.

MDMA itself is not approved for legal use because of its history as a recreational drug with the potential for harm, abuse, and addiction. But since 2017, the FDA has deemed the drug’s beneficial effects on PTSD symptoms to be “breakthrough therapy.”

How Does MDMA Work?

MDMA (which is short for 3, 4-methylenedioxymethamphetamine) causes the release of neurotransmitters, chemical messengers to brain cells that change brain activity. They include “feel-good” hormones like dopamine, serotonin, and norepinephrine, as well as oxytocin, prolactin, cortisol, and vasopressin.

The effects can include feelings of:

  • Empathy
  • Self-awareness
  • Sensory pleasure
  • More energy
  • Less anxiety
  • Ability to open up about emotions
  • Differences in how you see time and space

Mental health experts say these emotions may create an ideal setting for people with PTSD to open up about difficult emotions, do more self-reflection, and work through the events that may have triggered their condition.

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What Does MDMA-Assisted Therapy Look Like?

MDMA-assisted therapy sessions can take some time. You may need two or three sessions over 12 weeks to see the benefits. Your therapist will tell you more about what to expect and how to prepare yourself.

At each session, you’ll get a tablet or capsule with a 125-gram dose of the drug to swallow. Usually, it takes about 45 minutes to take effect.

Your doctor or therapist may follow up with a half-dose 2 hours after the first one if they feel it’s necessary.

The drug’s effects on your brain and body can last up to 8 hours, which gives you time to revisit and work through painful events.

At least two psychotherapists will be there for the whole session to help you through what can be a physically and emotionally draining process.

What’s the Evidence?

Scientists are still looking into MDMA’s benefits for people with PTSD in clinical trials. But the results have been promising.

The researchers say MDMA-assisted therapy may have more benefits than any other psychotherapy or medication that’s now used to treat severe PTSD.

In fact, they say PTSD symptoms can be controlled or reduced after one course of two or three sessions. And the benefits may be long-term: One study found that 67% of people reported that they no longer met the criteria for PTSD a year after they finished MDMA-assisted therapy.

These findings have led the FDA to grant MDMA-assisted therapy “expanded access status.” This means mental health professionals can give the drug to certain people who have very severe forms of PTSD that may be life-threatening, without a clinical trial. It can also be given to people whose PTSD doesn’t respond well to other types of therapy and who can’t be part of phase III clinical trials.

Because the treatment is given in a controlled setting, the potential for abuse is low. MDMA is also proving to be cheaper than other alternative therapies for severe PTSD that may take longer and need more drugs and professional assistance.

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What to Know About MDMA Use for PTSD

If you’ve been diagnosed with a severe form of PTSD and you’re interested in MDMA-assisted therapy, it’s important to remember that this treatment should be done only with expert help in a clinical setting.

MDMA-assisted therapy should not be confused with recreational ecstasy. Street drugs don’t have the same therapeutic effects, and you may not know their exact dose and purity.

In fact, researchers say ecstasy that’s bought illegally may have other ingredients, like methamphetamine, ketamine (a type of anesthetic), caffeine, or ephedrine. The combination can be dangerous for your health.

MDMA-assisted therapy isn’t right for everyone. You must be physically cleared before you can take it. If you’re interested in trying MDMA to help with severe PTSD symptoms, talk to your doctor or therapist about whether it might work for you.

WebMD Medical Reference Reviewed by Michael W. Smith, MD on May 13, 2021

Sources

SOURCES:

Mount Sinai: “Five Things to Know About MDMA-Assisted Psychotherapy for PTSD.”

Springer Link: “Long-term follow-up outcomes of MDMA-assisted psychotherapy for treatment of PTSD: a longitudinal pooled analysis of six phase 2 trials.”

Multidisciplinary Association for Psychedelic Studies: “MDMA-Assisted Therapy Study Protocols.”

Alcohol and Drug Foundation: “MDMA-assisted therapy for PTSD edges closer.”

National Institute on Drug Abuse: “What is MDMA?” “What are MDMA’s effects on the brain?”

FDA: “Expanded Access.”

PLOS One: “The cost-effectiveness of MDMA-assisted psychotherapy for the treatment of chronic, treatment-resistant PTSD.”

Psychiatry.org: “What Is Posttraumatic Stress Disorder?”

Annals of General Psychiatry: “MDMA-assisted psychotherapy for people diagnosed with treatment-resistant PTSD: what it is and what it isn’t.”

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