Ecstasy May Help in PTSD Treatment

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It has been noted that one in six soldiers returning from the wars in Iraq and Afghanistan are affected by posttraumatic stress disorder (PTSD). No one method of prevention or treatment has been found to work.

The most common treatments for PTSD are cognitive therapy, exposure therapy, eye movement desensitization and reprocessing (EMDR), and selective serotonin reuptake inhibitors (SSRIs) which include citalopram (Celexa), fluoxetine (such as Prozac), paroxetine (Paxil), and sertraline (Zoloft). The US Army has increased use of animal therapy, specifically with dogs and horses, to help veterans suffering from post-traumatic stress disorder.

Michael Mithoefer, MD, a psychiatrist in private practice in Mount Pleasant, S.C., and colleagues have reported online in the Journal of Psychopharmacology about the use of the illegal drug known as Ecstasy, ±3,4-methylenedioxymethamphetamine (MDMA) in the treatment of patients with refractory PTSD.

Mithoefer and colleagues received approval from the FDA and the Drug Enforcement Administration prior to recruiting 20 patients with PTSD (mean age 40; 85% female). All but one of the patients had PTSD resulting from crimes (ie. childhood physical or sexual abuse or rape). The average duration of PTSD among the study group was about 20 years, and previous psychotherapy or drug treatment had failed.

Twelve patients were randomized to pure MDMA (125 mg initially with an optional supplemental dose of 62.5 mg) during their experimental sessions and eight patients were assigned to placebo. All patients received intensive psychotherapy during two eight-hours sessions followed by an overnight stay. Researchers provided non-drug-assisted sessions before and after the drug- or placebo-assisted sessions.

The phase II study showed the use of MDMA during intensive psychotherapy resulted in at least a 30% reduction in PTSD score in 83.3% of the MDMA group compared with only 25% in the placebo group.

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Similar proportions of patients no longer met criteria for PTSD at the end of the study.

The authors note the need for further research, noting that these are only preliminary findings.

Mithoefer also warns that PTSD patients should not self-medicate with Ecstasy. There are risks such as elevated blood pressure and heart rate with the use of the drug. The Ecstasy purchased on the street may not be pure MDMA with the contaminates adding to the risk.

It should also be remembered that the use of MDMA in this study was conducted under strictly controlled conditions. Patients participated in therapy sessions. The MDMA was an adjunctive, not a replacement for therapy.

"The MDMA was not a 'magic bullet' that removed their PTSD," Mithoefer explained. "It seemed to act as a catalyst to therapy, and, as in any therapy for PTSD, the therapeutic process was often challenging."

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Source reference:
Mithoefer M, et al "The safety and efficacy of ±3,4-methylenedioxymethamphetamine-assisted psychotherapy in subjects with chronic, treatment-resistant posttraumatic stress disorder: the first randomized controlled pilot study" J Psychopharmacol 2010; DOI: 10.1177/0269881110378371.

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