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Can Ecstasy Help Treat PTSD?

Ongoing research shows MDMA ("Ecstasy") may help with treatment-resistant PTSD.

Michael and Ann Mitthoefer likely never expected the reaction they received after their research study was published online in the Journal of Psychopharmacology.  

A husband and wife team,   the Mitthoefers had developed a treatment combining psychotherapy with a maintenance regimen of MDMA (better known as “Ecstasy”) to treat posttraumatic stress in victims of violence.   Michael Mitthoefer is a psychiatrist while his wife Ann is a registered nurse and they began using MDMA to treat trauma patients in collaboration with the Multidisciplinary Association for Psychedelic Studies.  

Their study, conducted in collaboration with researchers from the Medical University of South Carolina, involved twenty-one subjects suffering  from severe posttraumatic stress who have been treatment-resistant for more conventional drug treatments.   The average length of time that the subjects in the study have been dealing with severe abuse was nineteen years.     Of the subjects,  twelve were assigned to the psychology and MDMA condition while the remaining subjects were assigned to psychotherapy only with an inactive placebo.   In all cases, the MDMA or the placebo was administered during two eight-hour sessions scheduled three to five weeks apart along with weekly therapy sessions.   

After the study was completed, all subjects were recruited for long-term follow up (LTFU) which extended for 17 to 74 months following the final MDMA session.  On average, almost all of the MDMA subjects, who had been suffering from long-term PTSD symptoms that were resistant to other forms of treatment, showed positive and statistically significant gains.   Based on these findings, the Mitthoefers and their fellow researchers argued that MDMA-assisted psychotherapy was  a safe and effective treatment for severe PTSD.

 According to the Mitthoefers, over 80 per cent of their subjects had improved to the point that they no longer met DSM-IV-TR criteria for PTSD following the trial compared to only 25 per cent of the control group.    These gains appear to persist over time with subjects remaining symptom-free years after their final MDMA session. 

Despite the small sample size and the caution by trauma experts that the results were still preliminary, news that the Mitthoeffers were planning to test their treatment on traumatized veterans led to them being besieged with requests for help from hundreds of returning veterans.  

Desperate for help after trying more conventional treatments,  many of these veterans have offered to travel long distances to receive help from the Mitthoefers’ South Carolina clinic.    While MDMA was first used for treatment after surfacing during the 1980s, it was criminalized in 1985 although regulators have allowed limited use by licensed medical clinics in recent years. 

If further research shows that MDMA-assisted psychotherapy is a safe and effective treatment for severe PTSD, it could provide a radical new approach for dealing with traumatized veterans haunted by their tours of duty overseas.  With approximately a third of the two to three million US soldiers  who have served in Afghanistan and Iraq believed to suffer from persistent posttraumatic symptoms, the demand for MDMA in treatment may only be just beginning.

Romeo Vitelli, Ph.D. is a psychologist in private practice in Toronto, Canada.

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