Successful Phase 3 MDMA Study Opens Door for FDA Approval
Traditional therapy has been a tool to treat PTSD (Post-Traumatic Stress Disorder) in veterans, first responders, sexual assault victims, and more. Previous studies had found that when therapists add MDMA -– also known as ecstasy or molly -– the symptoms of PTSD were alleviated to varying degrees.
Now, a large, successful study again showed MDMA-assisted therapy alleviates PTSD symptoms like no other treatment can. The study, published in Nature Medicine, found that 71 percent of people who did MDMA-assisted therapy no longer met criteria for PTSD.
The patients who did MDMA-assisted therapy saw improvements in their family, social and work life. By one measure, MDMA-assisted therapy was about twice as effective as therapy alone.
“It confirms MDMA works,” Matthias Liechti, a psychopharmacologist at the University of Basel in Switzerland, told Nature.
FDA Approval May Be Next
The study opens the door for legal MDMA-assisted therapy.
The study’s sponsors, the Multidisciplinary Association for Psychedelic Studies, have been working to legalize the treatment for more than two decades. MAPS has now done two large, placebo-controlled studies showing MDMA-assisted therapy allieviates PTSD.
This second large successful study means that MAPS can now seek approval from the Food and Drug Administration to roll out MDMA-assisted psychotherapy. In 2017, the FDA called MDMA-assisted therapy a “breakthrough.” The designation means the FDA will evaluate it quickly. The FDA may give the go-ahead as soon as next year. Clinics may start using the treatment soon after.
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A Sea Change Ahead
If the treatment is allowed, it would be a major shift in medicine and culture. There has been virtually no legal psychedelic use for four decades, except in small clinical trials like this one.
MDMA was outlawed in 1985. If approved, MDMA would move out of Schedule 1, and could be prescribed by doctors for use by therapists.
A legal psychedelic treatment would undercut the government’s view that drugs like MDMA, LSD and cannabis have no medical uses and are easy to abuse, and so shouldn’t be used by anyone for any reason.
MDMA-assisted therapy would give therapists a new, powerful tool to address hard-to-treat problems. MDMA-assisted therapy would give folks who are suffering legal access to an experience, MDMA, that can be among the most profound, gentle, loving, and opening feelings of a lifetime.
Study Results in Big Improvements
PTSD is painful, and can wreck lives. The condition is so torturous that people can drop out from work, friend groups, and families. PTSD affects about 5 percent of Americans. The best therapies available now only work for about 50 percent of people.
This study found that MDMA works because it gives people a different sense of themselves. MDMA “induces prosocial feelings and softens responses to emotionally challenging and fearful stimuli,” the study found. MDMA does this by “enhancing the ability of individuals with PTSD to benefit from psychotherapy by reducing sensations of fear, threat and negative emotionality.” The study’s lead, Jennifer Mitchell, told Nature that MDMA works as a “communication lubricant,” letting people talk to their therapist about their pain with less shame or horror.
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How the Study Worked
Over the course of 18 weeks, about 100 people with PTSD were given six 90-minute therapy sessions. Therapists did three, 8-hour “medicine” sessions in which they gave people blindfolds and played evocative music, and people settled down on a couch with a blanket. Half of the people got MDMA–between 160 and 180 milligrams. Half got a placebo.
The participants had lived with PTSD for an average of 16 years. They were combat veterans, survivors of sexual assault and childhood trauma. Many also suffered from things like depression, suicidal thoughts or substance abuse.
At the end, the patients were evaluated by two tests measuring PTSD and disability. The patients who got MDMA improved in many ways, including using less alcohol. Females did better than males. People from all kinds of different ethnic backgrounds improved.
The results in this clinical trial were similar to those in a study published in 2021, which found that 67 percent of people who got MDMA-assisted therapy no longer qualified for PTSD.
Notably, therapy alone was also effective at treating PTSD. Nearly half of the people in this study who got a placebo no longer met criteria for PTSD.
There were few adverse events; MDMA-assisted therapy was again proved broadly safe for well-screened participants who are guided by professionals.
An Uncertain Path Ahead
The director of MAPS, Rick Doblin, told the New York Times that “it feels a bit too early to really celebrate.” There are still many hurdles before regular people can access MDMA-assisted therapy, even after FDA approval. MAPS and the FDA have to agree on the protocols. How many therapy sessions will a client have to do? What kind of training, exactly, will therapists need? Where can the sessions take place?
There still aren’t enough therapists trained in MDMA-assisted therapy. The lack of trained therapists will likely be a huge bottleneck. MAPS is coordinating with partner organizations to increase the training opportunities.
“Drug-assisted therapy hasn’t been approved before, so there’s not a lot of precedent,” Amy Emerson, chief executive of the MAPS Public Benefit Corporation, told the Times.
