United Kingdom

Could ECSTASY cure PTSD? Patients given party drug before counselling respond better to treatment

Giving ecstasy to people with post-traumatic stress disorder before counselling can relieve them of their symptoms within weeks, a study has suggested.

Two-thirds of patients prescribed the illegal party drug alongside therapy no longer qualified for a PTSD diagnosis two months after treatment finished. 

Just 32 per cent who were given a placebo and counselling went into remission by the same point.

Nearly nine in 10 in the MDMA group reported a significant reduction in symptoms after just three therapy sessions - compared to six in 10 in the placebo group.  

MDMA, sometimes known as 'molly' in the US, is a popular nightclub drug in the rave and electronic dance music scenes.

Users often describe feeling euphoric, open and connected to themselves and those around them. Scientists have long suspected these properties could make it a powerful therapeutic for patients struggling with trauma. 

MDMA is currently a Class A drug in the UK and a Schedule 1 drug in the US, designated for substances with no legitimate medical purpose.

But the latest trial - run by New York City-based firm Mind Medicine - US puts MDMA one step closer to achieving medical approval in the US.  

The Food and Drug Administration needs a second positive phase three trial, which is currently underway, to give the drug the green light. Scientists hope it could get approval as early as 2023.

PTSD sufferers are being warned not to take the controversial pill without seeking medical advice. When bought on the street, ecstasy is often mixed with other dangerous chemicals. 

Giving ecstasy to people with post-traumatic stress disorder before counselling can relieve them of their symptoms within weeks, a study has suggested (file) 

More than 80 per cent of people given MDMA and counselling reported a significant reduction in their symptoms after just three sessions (shown far right) compared to about 60 per cent in the placebo group (left). After every session, the rave drug proved to have more of a positive impact on people's symptoms 

 PTSD symptoms in MDMA patients had a reduction - measured with the Clinician-Administered PTSD Scale (CAPS-5) - fell by 24.4 points compared to 13.9 in the placebo group

PTSD symptoms are triggered by flashbacks, nightmares, or even sounds and smells that cause sufferers' memories to come flooding back.  

MDMA is thought to dampen this response and allow people to reflect on their trauma without being overwhelmed. 

PTSD can trigger a host of other disorders including anxiety, depression, insomnia, substance abuse and eating disorders. 

THE PSYCHEDELIC DRUGS BEING STUDIED FOR THEIR MENTAL HEALTH BENEFITS 

In recent years, scientists have increasingly looked to psychedelic drugs as promising therapies for treatment-resistant mental illness.

Currently, such mind-altering drugs are largely illegal in the US.

But ongoing clinical trials suggest that drugs once beloved by hippies and club kids might have medical benefits, too.

Scientists are investigating:

KETAMINE

The club drug and tranquilizer has been in tests for treating depression for several years.

In March 2019, the US Food and Drug Administration approved the first nasal spray version of the drug.

Ketamine works much more quickly than traditional antidepressants, and scientists believe it encourages new neural connections that can help overwrite unhealthy, depressive thought patterns.

PSILOCYBIN

The active ingredient in 'magic mushrooms,' psilocybin is a powerful hallucinogen.

It, too, acts far more quickly than traditional drugs and is being analyzed for use in patients with both depression and PTSD.

Psyilocybin helps encourage neurplasticity and is thought to quiet down the 'default mode network' in the brain, and activate the 'salience network' that is involved in medication.

In August, the FDA cleared the largest clinical trial for psilocybin to-date.

MDMA

The club drug MDMA - sometimes called 'Molly' - is currently in trials to treat PTSD.

MDMA appears to quiet activity in the amygdala and hippocampus, regions of the brain involved in emotional processing and fear responses, which are over-active in those with PTSD.

Patients participating in MDMA trials take a dose of the drug, and remain in an eight-hour session with two therapists who guide their experience.

LSD

The psychedelic compound LSD has a similar structure to the brain chemical, serotonin.

LSD's discovery played a role in our discovery of how serotonin works in the brain and why imbalances of the neurochemical are involved in depression and anxiety.

Trials using LSD-assisted therapy to treat anxiety are ongoing and have shown early promise.

Sufferers include soldiers coming back from combat and people who have endured physical, emotional or sexual abuse.

The first group was given three MDMA-assisted counselling while the other group received a placebo during therapy sessions.

Participants received three counselling sessions spaced eight weeks apart, each lasting eight hours.

Before the first session began, participants in the MDMA group were given an 80mg dose of the drug in the form of a tablet.

Between 90 minutes and two-and-a-half hours later, patients received a top-up dose of 40mg.

In the second and third sessions, the initial dose was upped to 120mg, followed by a 60mg dose during the counselling.

For comparison, the average MDMA content of ecstasy pills on the street are around 125mg, although this can vary significantly. So-called ‘super pills’ can contain more than 250mg of MDMA.

Blood pressure, body temperature and heart rate were measured before the supplemental dose was given to make sure patients were tolerating the drug well. 

There were no serious adverse side effects reported, but some briefly experienced mild symptoms including nausea and loss of appetite.

Two months after treatment, 67 per cent of those in the MDMA group no longer qualified for a diagnosis of PTSD, compared with 32 per cent in the placebo group.  

As well alleviating their PTSD, researchers found the drug also helped lessen depressive symptoms.

Some 88 per cent of participants in the MDMA group experienced a significant reduction in symptoms, compared to 60 per cent in the placebo group. 

Even among people with the most difficult-to-treat PTSD, the combination of MDMA and therapy appeared to help.  

One limitation of the study was that it did not directly compare MDMA to current antidepressant drugs used to treat PTSD. 

Neurologist Jennifer Mitchell, from the University of California, who led the study, said that while these drugs numb the trauma, MDMA appears to help patients come to terms it.

She added: 'While many forms of PTSD therapy involve recalling previous trauma, the unique ability of MDMA to raise compassion and understanding while tamping down fear is likely what enables it to be so effective.' 

She said that those with the most debilitating form of PTSD benefited most from the MDMA and counselling combination.

'People with the most difficult-to-treat diagnoses, often considered intractable, respond just as well to this novel treatment as other study participants. 

'In fact, participants diagnosed with the dissociative subtype of PTSD experienced a greater reduction in symptoms than those without the dissociative subtype.' 

The second half of the phase III clinical trial is now underway, expanding the research to 50 more patients. 

Volunteers from the first half of the trial will continue to be followed for long-term research. 

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