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Researchers Weigh In on the Hype About MDMA Therapy

January 6, 2022 02:00 pm ET
Researchers Weigh In on the Hype About MDMA Therapy

Can you imagine what it is like to be overcome with intense feelings of euphoria? In the midst of all the madness caused by the motions of life, you take a pill and suddenly everything is brighter, more magical, and just feels so darn good? It turns out that this blissful drug, MDMA, has the potential to be used effectively as a treatment for certain conditions- some of which are in urgent need of effective medical assistance. 

What Is MDMA?

MDMA is short for 3,4-methylenedioxymethamphetamine, which is a synthetic drug that has the ability to act as a stimulant and hallucinogen, according to the NIH National Institute on Drug Abuse. It is also known in some circles as ecstasy or Molly depending on what form it is in. MDMA is derived from amphetamines which are classified as a group of stimulant drugs that increase certain chemicals in the brain like serotonin, dopamine, norepinephrine, and more. Importantly, there are key structural elements that make MDMA more structurally similar to hallucinogenic mescaline than to amphetamine or methamphetamine. Effects that can be expected from this substance include stimulation, arousal, and energy enhancement. In other words, one can expect an increase in awareness of the self and the body, intensified sensory perception, increased endurance, a more open disposition, reduced anxiety, distortion of time and space as well as rapidly elevating the mood – making one happy or euphoric. 

The NIH goes on to explain that MDMA is also available in the form of Molly. Molly is slang and short for molecular and is the crystalline powder form of MDMA. Molly can be consumed in the form of a capsule or powder while MDMA/ecstasy is consumed in the form of a tablet or capsule (12). However, Molly that has been seized by law enforcement has been found to contain other types of drugs too, some also contained no MDMA at all despite supposedly being the crystalline form of MDMA. Drugs like MDMA are derived from methamphetamines and often co-synthesized with other MDMA-like and mescaline-like drugs that are collectively called “designer drugs (6).”

While this article has been written for educational purposes, it is important to remember that this substance is listed as a Schedule 1 narcotic in the US. Purchasing this substance is therefore illegal and when accessed through illegal channels, is associated with multiple legal and health risks due to unregulated production. 

How Does MDMA Work?

MDMA triggers the immediate release of many neurotransmitters – which are the chemical messengers in the brain which inform changes in brain activity. The release of neurotransmitters includes dopamine, serotonin, norepinephrine, oxytocin, prolactin, cortisol, and vasopressin. 

MDMA is also a potent reuptake inhibitor of these compounds, which means they are not returned to the cells for breakdown and thus continue enhancing their effects. The release of these neurotransmitters is the reason for the following benefits. 

Benefits:

MDMA research has been given the green light by the US Food and Drug Administration (FDA) in order to assess its potential and efficacy for the treatment of post-traumatic stress disorder (PTSD). But what are the medicinal benefits associated with this synthetic substance which led to the FDA’s support? Well, let’s have a look at the following benefits which could be expected. 

  • Reducing anxiety and fear due to anxiolytic properties.
  • Enhancing interpersonal trust. 
  • Elevated mood (including boosting happiness).
  • Assisting with healing from psychological and emotional damage from traumas.
  • Enabling the terminally ill to come to terms with their death (13). 
  • Reductions in PTSD-related symptoms include intrusive memories (such as flashbacks), negative changes in thinking and mood (such as hopelessness) as well as changes in physical and emotional reactions (such as being easily startled or frightened). 

MDMA has also reportedly been used with over 1,000 individuals in clinical trials, with no serious adverse effects to report. 

Consuming Therapeutically and Recreationally

MDMA is a popular recreational drug that is consumed orally. According to the study by Stephen Peroutka that was published in 1990, the recreational use of MDMA in America has “never been documented adequately.” However, it is known that MDMA is popularly consumed at parties, raves, and any other social events which pair well with the stimulation and if you will, the ‘enlightenment’ associated with MDMA. 

The typical dosing for parties and raves is 1-2 tablets during the course of the party. Occasional case reports have noted doses as high as 10 tablets per party but usually with toxic outcomes (6). Meanwhile, such recreational use is often done in uncontrolled, uncontrollable, and non-clinical environments without the support of medical professionals – meaning that consumption in this capacity is substantially riskier.

When consumed therapeutically, MDMA is administered through a process known as MDMA-Assisted Therapy. Experts suggest that MDMA provides a “unique ability to allow patients to examine traumatic experiences without experiencing the attendant pain, which enables them to work through the issue with their therapist.” MDMA-assisted therapy is done over sessions where the patients will receive a tablet or capsule containing the substance. It would take around two to three sessions over 12 weeks in order to see results, however, this is dependent on the severity of the condition being treated.

Each capsule or tablet is said to contain a 125-gram dose of MDMA which can take effect around 45 minutes after consumption. The medical professional administering this treatment may give the patient a follow-up half-dose around 2 hours after the first one – although this only happens when deemed necessary. In this process, psychotherapists are available to facilitate the whole session in order to guide the patient through the process- whether physically, emotionally, or psychologically.  

Conditions That Could Benefit from MDMA Therapy 

Considering the nature and effects of this drug, it stands to reason that the conditions which would benefit most from MDMA would be those with cognitive conditions. 

PTSD

A study published in The Lancet Psychiatry found that MDMA was able to treat PTSD in the majority of their participants – which consisted of veterans, firefighters, police officers, and first responders. The study was funded by Multidisciplinary Association for Psychedelic Studies (MAPS), and led by Michael Mithoefer and Ann Mithoefer but includes several other medical professionals. One of them is Dr. Rick Doblin, executive director of MAPS, who stated that “in a few deep therapeutic sessions with MDMA, people can change decades and decades of patterns of fear that is based on certain emotions and that’s what is so remarkable about it.” 

Anxiety

Healthline explains that “MDMA has been noted for its anxiolytic (anti-anxiety) properties (14).” MAPs published results of their work exploring the second phase of a study on MDMA therapy for social anxiety in adults with autism. The results of the study are promising since the drug can suppress amygdala activity. The amygdala is a part of the brain which is responsible for fear and anxiety (3). Per the MAPS research group, these anxiolytic benefits may possibly extend to adults without autism spectrum disorder (ASD).

Depression

Unfortunately, the interaction between MDMA and depression has not been well-established but it is considered to be “theoretically well-grounded” due to the fact that the substance has the ability to elevate mood, reduce anxiety and open up the consumer’s disposition. There have been preliminary studies to suggest potential benefits of MDMA for depression, but these require much more follow-up before recommending (6).

Notably, a day or two after being taken in larger doses, the most common mental complaints include difficulty concentrating, depression, anxiety, and fatigue. Excessive MDMA may also cause serotonergic toxicity and permanent alterations in brain wiring, cardiovascular and liver toxicity, dehydration, hyperthermia, and fatalities from overdosing. 

Alcohol Addiction

The world’s first trial for MDMA as a treatment for alcohol addiction was started in 2017 and the results were recently published in 2021 (11). The participants of this study were considered to be heavy drinkers which have failed in previous attempts to stop. The study found promising results in helping reduce alcohol relapse and may thus assist with alcohol addiction which is rooted in trauma (1). as Dr. Ben Sessa explains, “Many of my patients who are alcoholics have suffered some sort of trauma in their past and this plays a role in their addiction.”

Research is currently limited on MDMA for therapy but thanks to the FDA approval for research and the promising potential of MDMA, people will soon have a better understanding of the workings of MDMA for therapeutic and medicinal purposes. Finding therapeutic solutions, such as MDMA, for conditions that are widely unresponsive to medication, such as PTSD and treatment-resistant depression, is more promising than ever. While MDMA stands a chance of gaining federal legalization in America before cannabis, one hopes that the FDA can continue approving the research of alternative means of treatment (including the likes of psilocybin) for the sake of the people. 


Note: Veriheal does not support illegally consuming therapeutic substances like MDMA but acknowledges that it transpires because of the current illicit status of both, which we strive to change by advocating for research, legal access, and responsible consumption. Always consult a physician before attempting alternative therapies.

1. Blackstone, H. (2019, August 19). MDMA treatment for alcoholism could reduce relapse, study suggests. The Guardian. Retrieved January 4, 2022, from https://www.theguardian.com/society/2019/aug/19/mdma-treatment-alcoholism-relapse-study 

2. CAN MDMA be used as medicine or therapy? Drug Policy Alliance. (n.d.). Retrieved January 4, 2022, from https://drugpolicy.org/drug-facts/can-mdma-be-used-medicine-or-therap

3. Danforth, A.L., Grob, C.S., Struble, C. et al. Reduction in social anxiety after MDMA-assisted psychotherapy with autistic adults: a randomized, double-blind, placebo-controlled pilot study. Psychopharmacology 235, 3137–3148 (2018). https://maps.org/wp-content/uploads/2014/07/2018_MAPS_Psychopharmacology_MAA-1_MDMA_Social_Anxiety_Autistic_Adults.pdf    

4. Devlin, H. (2017, June 30). World’s first trials of MDMA to treat alcohol addiction set to begin. The Guardian. Retrieved January 4, 2022, from https://www.theguardian.com/science/2017/jun/30/world-first-trials-mdma-treat-alcohol-addiction-set-begin 

5. Five things to know about MDMA-assisted psychotherapy for PTSD. Mount Sinai Today. (2020, February 20). Retrieved January 4, 2022, from https://health.mountsinai.org/blog/five-things-to-know-about-mdma-assisted-psychotherapy-for-ptsd/ 

6. Kalant H. (2001). The pharmacology and toxicology of “ecstasy” (MDMA) and related drugs. CMAJ : Canadian Medical Association journal = journal de l’Association medicale canadienne, 165(7), 917–928. https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC81503/

7. Mithoefer, M. C., Mithoefer, A. T., Feduccia, A. A., Jerome, L., Wagner, M., Wymer, J., Holland, J., Hamilton, S., Yazar-Klosinski, B., Emerson, A., & Doblin, R. (2018). 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy for post-traumatic stress disorder in military veterans, firefighters, and police officers: A randomised, double-blind, dose-response, phase 2 clinical trial. The Lancet Psychiatry, 5(6), 486–497. https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(18)30135-4/fulltext

8. Patel, R., & Titheradge, D. (2015). MDMA for the treatment of mood disorder: all talk no substance?. Therapeutic advances in psychopharmacology, 5(3), 179–188. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4502590/pdf/10.1177_2045125315583786.pdf 

9. Peroutka S.J. (1990) Recreational Use of MDMA. In: Peroutka S.J. (eds) Ecstasy: The Clinical, Pharmacological and Neurotoxicological Effects of the Drug MDMA. Topics in the Neurosciences, vol 9. Springer, Boston, MA. https://link.springer.com/chapter/10.1007/978-1-4613-1485-1_4

10. Quenqua, D. (2017, September 14). How a party drug could become the next blockbuster antidepression treatment. CNBC. Retrieved January 4, 2022, from https://www.cnbc.com/2017/09/14/how-a-party-drug-could-become-the-next-big-antidepression-treatment.html 

11. Sessa, B., Higbed, L., O’Brien, S., Durant, C., Sakal, C., Titheradge, D., Williams, T. M., Rose-Morris, A., Brew-Girard, E., Burrows, S., Wiseman, C., Wilson, S., Rickard, J., & Nutt, D. J. (2021). First Study of safety and tolerability of 3,4-methylenedioxymethamphetamine-assisted psychotherapy in patients with alcohol use disorder. Journal of Psychopharmacology, 35(4), 375–383. https://journals.sagepub.com/doi/abs/10.1177/0269881121991792

12. What is MDMA? National Institute on Drug Abuse. (2021, April 13). Retrieved January 4, 2022, from https://www.drugabuse.gov/publications/research-reports/mdma-ecstasy-abuse/what-mdma 

13. Wolfson, P. E., Andries, J., Feduccia, A. A., Jerome, L., Wang, J. B., Williams, E., Carlin, S. C., Sola, E., Hamilton, S., Yazar-Klosinski, B., Emerson, A., Mithoefer, M. C., & Doblin, R. (2020). MDMA-assisted psychotherapy for treatment of anxiety and other psychological distress related to life-threatening illnesses: a randomized pilot study. Scientific reports, 10(1), 20442. https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC7686344/

14. Mammoser, G. (2018, May 17). Ecstasy drug: Conditions it can help treat. Healthline. Retrieved January 4, 2022, from https://www.healthline.com/health-news/4-conditions-that-ecstasy-may-help-treat 

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Content Medically Reviewed By:<br> Dr. Abraham Benavides, MD
Content Medically Reviewed By:
Dr. Abraham Benavides, MD

Contributors: Sarah Walker
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