Research Underway on Psychedelic Treatments for PTSD

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Research Underway on Psychedelic Treatments for PTSD
Research Underway on Psychedelic Treatments for PTSD

According to the National Institute of Mental Health (NIMH), post-traumatic stress disorder (PTSD) affects approximately 7.7 million Americans, including both adolescents and adults. The condition can occur at any age in individuals who survived physical or sexual assault, abuse, disasters, or other traumatic events such as the death of a loved one. The condition also tends to develop more commonly in women than men.1

A combination of psychotherapy (exposure therapy, cognitive restructuring, and stress inoculation training) and/or antidepressive and antianxiety medications (sertraline, paroxetine, fluoxetine, and citalopram) is commonly used to treat PTSD.

In addition, other medications such as benzodiazepines and antipsychotics are also used.1 However, not all patients respond well to currently available psychotherapy approaches or medication, so ongoing research efforts are evaluating some unconventional approaches to treat this condition.

MDMA Potential Treatment Option for PTSD Sufferers

In a systemic review of the literature, C. Michael White, PharmD, of the University of Connecticut School of Pharmacy in Hartford, evaluated published studies in which 3,4-methylenedioxymethamphetamine (MDMA) was used in PTSD, examining each of the studies individually and then together to determine the strength of this body of literature. White assessed the strengths and weaknesses of these studies as well as what type of future studies would need to occur to determine if this therapy could be used more widely for patients with PTSD.2

Although the studies were preliminary, studied a small sample of people, and had strong input in design and analysis from an organization advocating the use of psychedelic drugs, the results were generally consistent and look very promising as an area for future research.

“The studies were done the same way – give [participants] several psychotherapy sessions and then put together a marathon psychedelic therapy session lasting most of the day. People would take MDMA in the morning, and in a new mental state would be more willing to share the feelings, emotions, and experiences that caused them to have PTSD,” said White.

After the first MDMA session, the patient followed up with regular psychotherapy sessions reinforcing the gains made before a second marathon MDMA and psychotherapy session occurs.

“The reductions in PTSD severity were pretty large and seem greater than the reductions that might be seen with standard prescription therapy or psychotherapy alone,” said White.

MDMA Mechanisms of Action Effective for Reducing PTSD Symptoms

According to White, MDMA is a very complex drug. It works similar to the SSRI drug, fluoxetine, increasing the amount of serotonin. It also has an amphetamine component increasing the level of energy, and a mescaline-like psychedelic effect where people see colors and feel sounds more intensively.

It also increases oxytocin concentrations, which helps patients feel a trusting bond with their psychotherapist. This is a good effect if the person needs to share their innermost horrific experiences in order to get a breakthrough.

“MDMA by itself will not alleviate PTSD symptoms, it helps the psychotherapy be more effective,” White said. “During the MDMA-psychotherapy sessions, the patients needed a lot of support, and the amphetamine component can be dangerous if it combined with physical activity so the procedures need to be tight and done by professionals.”   

Marijuana Currently Being Studied for Relief of PTSD Symptoms

Other unconventional approaches, including marijuana use, are currently under investigation. One study being planned by the University of Arizona in Phoenix is currently enrolling patients to evaluate the use of marijuana in U.S. veterans.3

“This study is under way, we will have to see results – when I look at illicit products, marijuana has advantages, it is legally available in some states for medical or recreational use. And it is easier to use it for study purposes and general acceptability is higher, but if you look at effects that you think would be good for PTSD, only the psychedelic effect would be apparent. You wouldn't have bonding component and won't have the feeling of extra energy needed for longer psychotherapy session,” said White.

Conclusion

Overall, patients with PTSD that is resistant and/or refractory to currently available psychotherapy approaches and medical interventions may benefit from the use of MDMA. However, the lack of acceptability, difficulty in acquiring an illicit drug, and lack of larger studies remain hindrances to long-term, widespread adoption.

References

  1. National Institute of Mental Health (NIMH). What is Post-traumatic Stress Disorder (PTSD). Available at: http://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml. Accessed: May 18, 2014.
  2. White, CM. 3,4 –Methylenedioxymethamphetamine's (MDMA's) impact on posttraumatic stress disorder. Annals of Pharmacotherapy. 2014: 1-8.
  3. Multidisciplinary Association for Psychedelic Studies. Marijuana for Symptoms of PTSD in Veterans of War. Available at: http://www.maps.org/research/mmj/marijuana_for_ptsd_study/. Accessed: May 18, 2014.
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