MDMA-assisted therapy for PTSD: MDMA or ecstasy was relegated as a potentially lethal party drug during decades. However, in a shocking twist of events, the FDA may soon be passing it as an acceptable form of treatment of PTSD with a final judgment coming as early as 2025. This is not some other experimental drug trial, it is a paradigm change and shift in the way we address trauma. Just consider a treatment that is effective to the point that 71 percent of clinical trial recipients no longer fulfilled the criteria of PTSD after only three sessions. That is no science fiction; it is already happening.
Well then why is FDA, which is usually reluctant to work with psychedelics, now willing to do this? It is found in the emerging data that MDMA in conjunction with a therapy can accomplish what has not been done with a pill or a talk session on its own: facilitate the processing of deep-rooted trauma by removing fear as the driving force. However, great promise attracts heated controversy. Is this the fate of mental health in the future, or are we ignoring that it is dangerous?
The Science: How MDMA Rewires Trauma in the Brain
MDMA does not simply deaden pain but it allows the mind to heal once again. Contrary to the conventional selective serotonin reuptake inhibitors that dull the emotions, MDMA increases serotonin, dopamine, and oxytocin-building a situation in which trauma patients are able to relive bad experiences without being overwhelmed. Researchers in Nature Medicine 2021 wrote, 67% of individuals in MDMA-assisted treated had no longer been eligible to PTSD after 18 months, in contrast to 32% in those brought in with a placebo.
Consider an example of an ex-Marine Corps who experienced PTSD and had to live through it for years (Jason). Conventional therapy was just but window dressing. He was later enrolled into a clinical trial. Hoag says it was like someone finally gave him a flash light in a dark room. I was able to discuss the trauma without panicking as I was able to do so for the first time. His experience is not unusual, as dozens of other soldiers, survivors of assaults, as well as first responders testify of breakthrough.
However, there is a twist there, MDMA is not a magic bullet. It can only be effective combined with intensive psychotherapy. Before, during, and after sessions, patients who meet with trained therapists are kept in safe conditions. The time they spend with therapists ensures their safety and provides them with the most beneficial care.
Why the FDA Is Betting Big on Psychedelics
FDA does not approve treatments in a hasty manner. MDMA received its Breakthrough Therapy characteristic in 2017 as after initial experiments the results were out of this world. At the moment, the safety and efficacy have been proven due to the Phase 3 results, so it is likely to be approved.
- The timeline: In case of a greenlight, MDMA-assisted therapy clinics should start operating at the end of 2025.
- The price: Similar estimates predict between 10 000 and 15 000 dollars per course of the treatment- casting a doubt on whether it will be eligible to be covered by insurance.
- The precedent: the use of ketamine against depression has been approved in 2019, which demonstrated that psychedelics found their place in medicine as well.
However, not all people are swayed. Dr. The most leading psychiatrist Allen Frances warns against a condition of hyping the drug: we are on the brink of overhyping this. MDMA is destabilizing to some of the patients.” However, advocates admit that rigid clinical requirements (no take-aways, no tolerance without supervision by a therapist) help to reduce risks.
The Controversy: Healing Tool or Slippery Slope?
The critics fear recreational abuse using the history of MDMA as a club drug. Other people are afraid of the long term effects- what happens when the therapy is over?
Here is what people overlook, though:
- In controlled conditions, bad trips are infrequent (< 5 % in trials).
- The actual danger? Refraining to treat PTSD. The veteran suicide is 1.5 times that of civilians.
According to Dr. Julie Holland, a psychopharmacologist, “we have tried to treat PTSD patients with mediocre efficacies over the past few decades. We got something which works, and we hesitate?
What’s Next? Mental Health Revolution, Or fakeness?
Assuming that MDMA-assisted treatment is authorized, the number of patients with PTSD will eventually decrease by at least five times in ten years. Nevertheless difficulties still exist:
- Shortage of therapists (MAPS is training hundreds of them, but demand is about to explode).
- Obstacles to insurance (Will it be covered by Medicare? Unclear).
- The domino effect (Psilocybin as a treatment of depression is already at Phase 3 trials).
In conclusion, the opinion of society on antidepressants changed in the past, i.e. what they once labeled a happy pill, later on becoming a lifesaver. Will MDMA be too? Or will stigma shut it off? This is one thing that people can be sure about, the future of mental health is not restricted to new medications. It is that hoping to heal differently.
That is what you think? Is MDMA as a saleable drug too risky to keep it in clinics? Let’s discuss.