November 27th, 2012
MDMA-Ecstasy Drug Makes Psychotherapy Effective in Treating PTSD
Whether a person is traumatized by sexual abuse, crime, war or the workplace, their resulting posttraumatic stress disorder (PTSD) can be resistant to traditional psychotherapy. A breakthrough alternative may be on the horizon — methylenedioxymethamphetamine (MDMA) in pure form combined with psychotherapy. According to the Multidisciplinary Association for Psychedelic Studies, which funded the research, MDMA is not the same as Ecstasy. Substances sold on the street under the name Ecstasy do often contain MDMA, but frequently also contain ketamine, caffeine, BZP, and other narcotics and stimulants.
A randomized, double-blind and placebo-controlled study of twenty-one individuals with treatment-resistant PTSD was conducted by Michael Mithoefer, M.D. with co-therapist Ann Mithoefer, B.S.N. in Charleston, SC. The early phase was completed in 2008 with results published in the Journal of Psychopharmacology in 2010.
Over three years later, the long-term follow up was completed by the research-clinicians. The positive benefits from the MDMA + psychotherapy protocol lasted for 17 of 20 individuals available for the study. They reported minor to no symptoms. New life stressors caused relapse for the others. The follow-up study also appeared in the Journal of Psychopharmacology on Nov. 10, 2012.
Because of the overwhelming need for PTSD treatment for military veterans, the Mithoefers have been deluged by vets seeking treatment. However, the FDA allows only 24 participants in a study that uses an experimental drug like MDMA.
Benedict Carey, science writer for the New York Times wrote that MDMA, better known as Ecstasy, a party drug that surfaced in the 1980s and ’90s that can induce pulses of euphoria and a radiating affection. Government regulators criminalized the drug in 1985, placing it on a list of prohibited substances that includes heroin and LSD. But in recent years, regulators have licensed a small number of labs to produce MDMA for research purposes.
Carey described the Mithoefer approach
The Mithoefers administer the MDMA in two doses over one long therapy session, which comes after a series of weekly nondrug sessions to prepare. Three to five weeks later, they perform another drug-assisted session; and again, patients engage in 90-minute nondrug therapy before and after, once each week.
Most have found that their score on a standard measure of symptoms — general anxiety, hyperarousal, depression, nightmares — drops by about 75 percent. That is more than twice the relief experienced by people who get psychotherapy without MDMA, the Mithoefers said.
The couple works as a team, sitting with the patient for as long as the altered state lasts. “It’s very much a nondirected therapy,” Dr. Mithoefer said. “We’re with them for 8 to 10 hours, usually, and we alternate between having them talk to us and having them focus on the trauma. Part of what we’re trying to do is help the person stay with the memory even if it’s difficult.”
For many people, the experience in treatment is emotionally vivid, Dr. Mithoefer continued. The drug does not produce a “high,” but it usually brings some tranquility.
Studies of people taking MDMA suggest that the drug induces, among other things, the release of a hormone called oxytocin, which is thought to increase sensations of trust and affection. The drug also seems to tamp down activity in a brain region called the amygdala, which flares during fearful, threatening situations.
In interviews, two people who have had the therapy — one, Anthony, currently in the veterans study, and another who received the therapy independently — said that MDMA produced a mental sweet spot that allowed them to feel and talk about their trauma without being overwhelmed by it.
“It changed my perspective on the entire experience of working at ground zero,” said Patrick, a 46-year-old living in San Francisco, who worked long hours in the rubble after the Sept. 11, 2001, attacks searching in vain for survivors, as desperate family members of the victims looked on, pleading for information. “At times I had this beautiful, peaceful feeling down in the pit, that I had a purpose, that I was doing what I needed to be doing. And I began in therapy to identify with that,” rather than the guilt and sadness.
It is noteworthy that no government or military agency funds this research that could help people wounded in the military. The U.S. War on Drugs interferes. All of this research is funded by nonprofit organizations like MAPS that has made a 10 year $15 million commitment to the work.
The Mithoefers’, Annie and Michael, practice is at 708 Scott St, Mount Pleasant, SC 29464 (843) 849-6899.
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