Could ecstasy ease PTSD symptoms?

Adding MDMA - otherwise known as the party drug ecstasy - to talk therapy may help patients cope with symptoms of post-traumatic stress disorder (PTSD), according to a preliminary study presented at the Psychedelic Science in the 21st Century meeting.

The improvements endured long-term for most patients, said lead investigator Dr Michael Mithoefer, a psychiatrist in private practice in Charleston, South Carolina.

MDMA gained notoriety in the 1980s as a recreational drug, and the Drug Enforcement Agency outlawed it in 1985. Before then, a small network of therapists had experimented with the drug as an adjunct to traditional talk therapy.

The study

The non-profit Multidisciplinary Association of Psychedelic Studies (MAPS) launched Mithoefer's study in 2004 as the first step toward developing MDMA as a prescription medicine for use in therapists' offices.

There were 20 patients in the study, all with moderate to severe PTSD that had not improved with standard treatments. The researchers found that patients taking MDMA had lower scores on standard PTSD symptom tests two months after the study, and also after more than three years.

More than half of the patients - 13 - no longer met criteria for PTSD. However, two patients "clearly relapsed", Mithoefer told Reuters Health, and it's unknown what happened to four of the patients.

Many of the patients also resumed taking antidepressants and anti-anxiety drugs after the study, but "they were on many fewer medications than when they started" the trial, Mithoefer said.

Drug reduces fear

"We think MDMA gives people four to six hours...where they can process their trauma," said Mithoefer. The drug appears to reduce the fear of engaging with painful memories, he added, as all patients receiving MDMA voluntary recounted their trauma while under its influence.

The two to three day long MDMA sessions were sandwiched between 10 to 15 sessions of traditional psychotherapy. Mithoefer reported no significant side effects after a total of 51 MDMA sessions.

Although the study was "blinded", meaning that patients did not know whether they were receiving MDMA, Mithoefer acknowledged that the drug often evokes powerful emotions, which may have tipped off patients and their therapists. Studies now getting underway will hopefully address this limitation, he said.

A psychiatrist not involved in the study, Dr Ben Sessa of the Somerset National Health Service Trust in the United Kingdom, said MDMA-assisted psychotherapy "is in a very experimental phase" and that it "obviously requires a lot of time, effort, and skill on the part of the therapist". Still, he called the findings "hugely significant". - (Brian Vastag/Reuters Health, April 2010)