MDMA-assisted psychotherapy

Last updated

MDMA-assisted psychotherapy is the use of prescribed doses of MDMA as an adjunct to psychotherapy sessions. Research suggests that MDMA-assisted psychotherapy for post-traumatic stress disorder (PTSD), including Complex PTSD, might improve treatment effectiveness. [1] [2] [3] In 2017, a Phase II clinical trial led to "breakthrough therapy" designation by the US Food and Drug Administration (FDA) for potential use as a treatment for PTSD. [4] [5]

Contents

MDMA-assisted psychotherapy is currently under investigation as a treatment for various other mental health disorders, inclusing Major Depressive Disorder, social anxiety in autistic individuals, alcohol use disorder, and mood disturbances in individuals facing life-threatening illnesses. [6] [7] [8] The research is controversial [9] [10] in part because recreational MDMA use has been associated with harmful effects among some users. [11] [9] [12]

Therapeutic effects

Post-traumatic stress disorder (PTSD) is most commonly treated by cognitive behavioral therapy (particularly prolonged exposure and cognitive processing therapy), eye movement desensitization and reprocessing, and psychodynamic psychotherapy. However, over half of these patients continue to have PTSD after completing therapy, with results from military PTSD being especially poor. [13]

PTSD is best treated when a patient is in the 'optimal arousal zone'. This is the zone in which emotions are engaged yet not overwhelming. In this zone, four symptom clusters of PTSD are sedated: [10] These are:

  1. re-experiencing
  2. avoidance
  3. negative alterations in cognition/mood
  4. alterations in arousal and reactivity

Subjects with PTSD exhibit extreme emotional numbing or anxiety and struggle to remain in the optimal arousal zone during conservative therapies. Threatening interpretations of memories are reinforced when patients are in low emotional states. [14] If traumatic memories are revisited in therapy when a patient is not within the optimal arousal state, therapy for PTSD can actually increase the patient's trauma. [14]

When used in therapy, MDMA has been reported to increase empathy, closeness between patient and therapist, relaxation, motivation to engage with therapy and introspective thought, and reduce depression and anxiety. MDMA makes it easier for a patient to stay in the optimal arousal zone by decreasing feelings of anxiety and defensiveness when revisiting traumatic memories. [10] By increasing feelings of closeness and empathy, it can improve the patient's trust in the therapist and encourage introspective thought to reassess memories and actions. Furthermore, research suggests that treatment may improve the quality of sleep of individuals affected by PTSD-related sleep disturbances. [15] It is believed that these factors may increase the success rate of psychotherapy.

Adverse effects, which can last from a few hours to several days, include diminished appetite, anxiety, headache, jaw tightness, tinnitus, nausea, asthenia, fatigue, acute sinusitis, nasopharyngitis, upper respiratory tract infection, disturbance in attention, tremor, tics, dysuria, erythema, and depression. [16]

Research

With FDA approval granted in 2017, MDMA has been authorized for use in research related to psychotherapy. [4] MDMA-assisted psychotherapy is currently under investigation as a potential treatment for various mental health disorders, encompassing PTSD, Major Depressive Disorder, social anxiety in autistic individuals, [6] alcohol use disorder, [7] and mood disturbances in individuals facing life-threatening illnesses. [8] A large proportion of this research has been focused on PTSD and Major Depressive Disorder.

PTSD

A phase 3 study indicated that MDMA-assisted therapy represents a potential breakthrough treatment for severe PTSD that merits expedited clinical evaluation. [17] Based on this study, MDMA-assisted psychotherapy was granted breakthrough therapy designation by the FDA, a designation that indicates that there is preliminary evidence that an intervention might offer a substantial improvement over other options for a serious health condition. [5] However, given the lack of blinding, several researchers have postulated that the results of the phase 3 trial might be heavily influenced by expectancy effects. [18] [19] There are no trials comparing MDMA-assisted psychotherapy to already existing first-line psychological treatments for PTSD which seems to attain similar or elevated symptom reduction compared with that due to MDMA-assisted psychotherapy based on indirect evidence. [20]

Major Depressive Disorder

There have been several studies that investigated MDMA-assisted psychotherapy as a potential treatment for Major Depressive Disorder (MDD). A analysis of six phase 2 trials showed a trend toward significance, while a phase 3 trial reported that MDMA-assisted psychotherapy had antidepressant effects. Given that unprocessed trauma is considered a causative factor in some individuals with depression, it has been proposed that the benefit observed in PTSD trials might be applicable to MDD as well. [21]

Neuroscience & mechanism of action

Chemical compound of MDMA MDMA molecule from xtal ball.png
Chemical compound of MDMA

PTSD inhibits a subject's ability to respond appropriately to trauma-related stimuli. [10] The current model of PTSD proposes that it results from amplified and uncontrolled responses from the amygdala to trauma-specific cues. [14] Oxytocin, which is increased by MDMA, has been found to increase trust and emotional awareness and reduce amygdala responses as well as reduce coupling of the amygdala to brainstem regions associated with autonomic and behavioral characteristics of fear. [22] [23] [24] It has been proposed that these effects foster memory reconsolidation by allowing the patient to access the traumatic memory while feeling detached from the sense of imminent threat. [14]

History

Alexander Shuglin, an American chemist who helped publish the first report on the effects of MDMA in humans Alexander Shulgin cropped.jpg
Alexander Shuglin, an American chemist who helped publish the first report on the effects of MDMA in humans

MDMA was first synthesized by the German pharmaceutical company Merck KGaA in 1912 as an intermediate in the synthesis of a potential blood clotting medication. Its psychoactive effects were not noted until the early 1960s. In the 1960s and 1970s, the drug was used in psychotherapy, although it was not an approved drug, and no clinical trials had been performed. Alexander Shuglin, an American chemist, synthesized MDMA in order to investigate its properties and was responsible for introducing the compound to a small number of American psychiatrists in the early 1970s. Shuglin and another chemist, David E. Nichols, are credited with publishing the first report regarding the effects and pharmacology of MDMA in humans. [25]

Psychotherapists using MDMA for therapeutic purposes initially desired to keep its use within the clinical research community; however, the medication gained popularity in the club scene in the early 1980s. This eventually lead to the drug being classified as a Schedule One substance by the US Drug Enforcement Administration (DEA) in 1986. The scheduling of MDMA made it illegal to manufacture, possess, or distribute, essentially ending the practice of MDMA-assisted psychotherapy in the US. Despite this, MDMA continued to be used recreationally in the club and rave scene. [25]

Switzerland continued to study the drug for use in individual, couple, and group therapies until 1993, when the Swiss Ministry of Health withdrew permission to use MDMA and LSD by psychiatrists due to concerns about a lack of research methodology. Over 100 patients in Switzerland with a variety of mental illnesses were treated with MDMA-assisted psychotherapy during this time frame. [26]

Legality

In 1986, MDMA was classed as a Schedule One drug by the United Nations according to its Convention on Psychotropic Substances of 1971 due to increasing rates of non-clinical use and police seizures, along with its high potential for abuse. [10] [25] MDMA has remained a Schedule One substance since 1986, and most research was stopped at that time. In response to this, researchers interested in MDMA for use in psychotherapy founded and funded the US-based non-profit research organization, Multidisciplinary Association for Psychedelic Studies (MAPS). [25] MAPS is now one of the leading organizations funding research on psychedelic and controlled substances.

The US Food and Drug Administration (FDA) and Drug Enforcement Administration (DEA) granted approval for researching MDMA's efficacy as an adjunct to psychotherapy in 2004, and the first trial was carried out in 2011. [10] [27] In 2023, MAPS announced that it is compiling data from 18 different phase 2 and phase 3 studies with plans to file a New Drug Application with the FDA. MAPS hopes to receive FDA approval by the end of 2024. [27]

In July 2023, Australia became the first country to approve the legal use of MDMA-assisted psychotherapy for the treatment of depression and PTSD. [28]

Controversy & safety

MDMA's effects vary across people and settings and include adverse outcomes. [9] [12] The drug causes neurotransmitter activation across the main neural pathways (including serotonin and dopamine, noradrenaline) that can result in large mood swings. The memories that emerge under the influence of MDMA can evoke unwanted emotions. [9] Side effects of MDMA use by recreational users include appetite fluctuations, food cravings, and disordered eating. [9]

Once the effects of MDMA wear off, there is a "period of neurochemical depletion" that invokes anhedonia, lethargy, anger, depression, irritability, brooding, greater everyday stress, altered pain thresholds, changes in sleep, and bad dreams, especially in female participants. [9] The symptoms are thought to be due to the depletion of serotonin, as a result of the large release of serotonin triggered by MDMA and have been called "neurotoxic in terms of causing serotonergic dysfunction." [9]

There are also concerns surrounding "drug-dependent learning" — the theory that patients will return to the drug to access the state they were in when on the drug in therapy. [9]

There were 92 MDMA-related deaths in England and Wales in 2018, up from 56 the year before, [29] and 10,000 hospitalizations for MDMA-related illness/injury in 2011 in the US. [11] However, as of 2021, there have been no such cases reported for clinical settings.

Media reports and statements of academic authors have often transmitted the view of MDMA as a possible medicine or treatment rather than as an adjunct to psychotherapy. [10] This has been considered dangerous because it could lead people to believe that MDMA is an effective treatment alone, without concomitant psychotherapy. [10]

See also

Related Research Articles

<span class="mw-page-title-main">MDMA</span> Psychoactive drug, often called ecstasy

3,4-Methyl​enedioxy​methamphetamine (MDMA), commonly known as ecstasy, and molly or mandy, is a potent empathogen–entactogen with stimulant and minor psychedelic properties, primarily used for recreational purposes. The purported pharmacological effects that may be prosocial include altered sensations, increased energy, empathy, and pleasure. When taken by mouth, effects begin in 30 to 45 minutes and last three to six hours.

Post-traumatic stress disorder (PTSD) is a mental and behavioral disorder that develops from experiencing a traumatic event, such as sexual assault, warfare, traffic collisions, child abuse, domestic violence, or other threats on a person's life or well-being. Symptoms may include disturbing thoughts, feelings, or dreams related to the events, mental or physical distress to trauma-related cues, attempts to avoid trauma-related cues, alterations in the way a person thinks and feels, and an increase in the fight-or-flight response. These symptoms last for more than a month after the event. Young children are less likely to show distress, but instead may express their memories through play. A person with PTSD is at a higher risk of suicide and intentional self-harm.

<span class="mw-page-title-main">Sertraline</span> Antidepressant (SSRI class) medication

Sertraline, sold under the brand name Zoloft among others, is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class. The efficacy of sertraline for depression is similar to that of other antidepressants, and the differences are mostly confined to side effects. Sertraline is better tolerated than the older tricyclic antidepressants. Sertraline is effective for panic disorder, social anxiety disorder, generalized anxiety disorder (GAD), and obsessive–compulsive disorder (OCD). However, for OCD, cognitive behavioral therapy, particularly in combination with sertraline, is a better treatment. Although approved for post-traumatic stress disorder (PTSD), sertraline leads to only modest improvement in this condition. Sertraline also alleviates the symptoms of premenstrual dysphoric disorder (PMDD) and can be used in sub-therapeutic doses or intermittently for its treatment.

<span class="mw-page-title-main">Dialectical behavior therapy</span> Psychotherapy for emotional dysregulation

Dialectical behavior therapy (DBT) is an evidence-based psychotherapy that began with efforts to treat personality disorders and interpersonal conflicts. Evidence suggests that DBT can be useful in treating mood disorders and suicidal ideation as well as for changing behavioral patterns such as self-harm and substance use. DBT evolved into a process in which the therapist and client work with acceptance and change-oriented strategies and ultimately balance and synthesize them—comparable to the philosophical dialectical process of thesis and antithesis, followed by synthesis.

<span class="mw-page-title-main">Empathogen–entactogen</span> Class of psychoactive drugs that produce empathic experiences

Empathogens or entactogens are a class of psychoactive drugs that induce the production of experiences of emotional communion, oneness, relatedness, emotional openness—that is, empathy or sympathy—as particularly observed and reported for experiences with 3,4-methylenedioxymethamphetamine (MDMA). This class of drug is distinguished from the classes of hallucinogen or psychedelic, and amphetamine or stimulants. Major members of this class include MDMA, MDA, MDEA, MDOH, MBDB, 5-APB, 5-MAPB, 6-APB, 6-MAPB, methylone, mephedrone, GHB, αMT, and αET, MDAI among others. Most entactogens are phenethylamines and amphetamines, although several, such as αMT and αET, are tryptamines. When referring to MDMA and its counterparts, the term MDxx is often used. Entactogens are sometimes incorrectly referred to as hallucinogens or stimulants, although many entactogens such as ecstasy exhibit psychedelic or stimulant properties as well.

<span class="mw-page-title-main">Generalized anxiety disorder</span> Long-lasting anxiety not focused on any one object or situation

Generalized anxiety disorder (GAD) is a mental and behavioral disorder, specifically an anxiety disorder characterized by excessive, uncontrollable and often irrational worry about events or activities. Worry often interferes with daily functioning, and individuals with GAD are often overly concerned about everyday matters such as health, finances, death, family, relationship concerns, or work difficulties. Symptoms may include excessive worry, restlessness, trouble sleeping, exhaustion, irritability, sweating, and trembling.

Psychedelic therapy refers to the proposed use of psychedelic drugs, such as psilocybin, MDMA, LSD, and ayahuasca, to treat mental disorders. As of 2021, psychedelic drugs are controlled substances in most countries and psychedelic therapy is not legally available outside clinical trials, with some exceptions.

The Multidisciplinary Association for Psychedelic Studies (MAPS) is an American nonprofit organization working to raise awareness and understanding of psychedelic substances. MAPS was founded in 1986 by Rick Doblin and is now based in San Jose, California.

<span class="mw-page-title-main">Rick Doblin</span> American drug activist

Richard Elliot Doblin is an American drug activist and executive who is the founder and former executive director of the Multidisciplinary Association for Psychedelic Studies (MAPS).

<span class="mw-page-title-main">Hallucinogen persisting perception disorder</span> Medical condition

Hallucinogen persisting perception disorder (HPPD) is a non-psychotic disorder in which a person experiences apparent lasting or persistent visual hallucinations or perceptual distortions after a previous use of drugs, including but not limited to psychedelics, dissociatives, entactogens, tetrahydrocannabinol (THC), and SSRIs. Despite being designated as a hallucinogen-specific disorder, the specific contributory role of psychedelic drugs is unknown.

<span class="mw-page-title-main">Guanfacine</span> Medication used for high blood pressure and ADHD

Guanfacine, sold under the brand name Tenex (immediate-release) and Intuniv (extended-release) among others, is an oral alpha-2a agonist medication used to treat attention deficit hyperactivity disorder (ADHD) and high blood pressure. Guanfacine is FDA-approved for monotherapy treatment of ADHD, as well as being used for augmentation of other treatments, such as stimulants. Guanfacine is also used off-label to treat tic disorders, anxiety disorders and PTSD.

<span class="mw-page-title-main">Psychological intervention</span>

In applied psychology, interventions are actions performed to bring about change in people. A wide range of intervention strategies exist and they are directed towards various types of issues. Most generally, it means any activities used to modify behavior, emotional state, or feelings. Psychological interventions have many different applications and the most common use is for the treatment of mental disorders, most commonly using psychotherapy. The ultimate goal behind these interventions is not only to alleviate symptoms but also to target the root cause of mental disorders.

Prolonged exposure therapy (PE) is a form of behavior therapy and cognitive behavioral therapy designed to treat post-traumatic stress disorder. It is characterized by two main treatment procedures – imaginal and in vivo exposures. Imaginal exposure is repeated 'on-purpose' retelling of the trauma memory. In vivo exposure is gradually confronting situations, places, and things that are reminders of the trauma or feel dangerous. Additional procedures include processing of the trauma memory and breathing retraining.

PTSD or post-traumatic stress disorder, is a psychiatric disorder characterised by intrusive thoughts and memories, dreams or flashbacks of the event; avoidance of people, places and activities that remind the individual of the event; ongoing negative beliefs about oneself or the world, mood changes and persistent feelings of anger, guilt or fear; alterations in arousal such as increased irritability, angry outbursts, being hypervigilant, or having difficulty with concentration and sleep.

<span class="mw-page-title-main">Psilocybin therapy</span> Experimental use of psilocybin to treat anxiety & depression

Psilocybin therapy is the use of psilocybin in treating a range of mental health conditions, such as depression, anxiety, addictions, obsessive compulsive disorder, and psychosis. It is one of several forms of psychedelic therapy under study. Psilocybin was popularized as a psychedelic recreational drug in the 1970s and was classified as a Schedule I drug by the DEA. Research on psilocybin as a medical treatment was restricted until the 1990s because of the sociocultural fear of dependence on this drug. As of 2022, psilocybin is the most commonly researched psychedelic due to its safety and low potential for abuse and dependence. Clinical trials are being conducted at universities and there is evidence confirming the use of psilocybin in the treatment of depression, PTSD and end of life anxiety.

Una D. McCann is a board certified psychiatrist and researcher at Johns Hopkins School of Medicine in the Department of Psychiatry. She is also the Director of the Anxiety Disorders Program, and Co-Director of the Center for Interdisciplinary Sleep Medicine and Research, and Associate Program Director at the Johns Hopkins Bayview Medical Center. McCann is considered to be an expert in anxiety and stress disorders and her primary areas research revolves around amphetamine-induced monoamine neurotoxicity and neurobiology of anxiety disorders.

Psychoplastogens are a group of small molecule drugs that produce rapid and sustained effects on neuronal structure and function, intended to manifest therapeutic benefit after a single administration. Several existing psychoplastogens have been identified and their therapeutic effects demonstrated; several are presently at various stages of development as medications including Ketamine, MDMA, Scopolamine, and the serotonergic psychedelics, including LSD, psilocin, DMT, and 5-MeO-DMT. Compounds of this sort are being explored as therapeutics for a variety of brain disorders including depression, addiction, and PTSD. The ability to rapidly promote neuronal changes via mechanisms of neuroplasticity was recently discovered as the common therapeutic activity and mechanism of action.

Psychedelic treatments for trauma-related disorders are the use of psychedelic substances, either alone or used in conjunction with psychotherapy, to treat trauma-related disorders. Trauma-related disorders, such as post-traumatic stress disorder (PTSD), have a lifetime prevalence of around 8% in the US population. However, even though trauma-related disorders can hinder the everyday life of individuals with them, less than 50% of patients who meet criteria for PTSD diagnosis receive proper treatment. Psychotherapy is an effective treatment for trauma-related disorders. A meta-analysis of treatment outcomes has shown that 67% of patients who completed treatment for PTSD no longer met diagnostic criteria for PTSD. For those seeking evidence-based psychotherapy treatment, it is estimated that 22-24% will drop out of their treatment. In addition to psychotherapy, pharmacotherapy (medication) is an option for treating PTSD; however, research has found that pharmacotherapy is only effective for about 59% of patients. Although both forms of treatment are effective for many patients, high dropout rates of psychotherapy and treatment-resistant forms of PTSD have led to increased research in other possible forms of treatment. One such form is the use of psychedelics.

Ketamine-assisted psychotherapy(KAP) is the use of prescribed doses of ketamine, the drug, as an adjunct to psychotherapy sessions. KAP shows significant potential in treating mental disorders such as treatment-resistant depression (TRD), anxiety, obsessive–compulsive disorders (OCD), post-traumatic stress disorders (PTSD), and other conditions. It can also be used for those experiencing substance abuse and physical pain. While it is primarily used as a veterinary anaesthetic, ketamine has also been found to have rapid analgesic and hallucinogenic effects, which has sparked interest in its use as an antidepressant. Despite initial trials of its use in the treatment of mental disorders focussing primarily on its antidepressant effects, newer studies are attempting to harness its psychedelic effects to bring about altered states of consciousness, which will augment the adjunct psychotherapy. Ketamine's neuroplasticity-promoting effects strengthen the cognitive restructuring that takes place through traditional psychotherapy, thereby leading to long-lasting behavioural change. KAP offers promising directions for research on new antidepressant alternatives, but is still not sufficiently defined or evaluated as a treatment combination.

References

  1. ↑ Bahji A, Forsyth A, Groll D, Hawken ER (January 2020). "Efficacy of 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy for posttraumatic stress disorder: A systematic review and meta-analysis". Progress in Neuro-Psychopharmacology & Biological Psychiatry. 96: 109735. doi:10.1016/j.pnpbp.2019.109735. PMID   31437480. S2CID   201069918.
  2. ↑ Smith KW, Sicignano DJ, Hernandez AV, White CM (October 2021). "MDMA-Assisted Psychotherapy for Treatment of Posttraumatic Stress Disorder: A Systematic Review With Meta-Analysis". Journal of Clinical Pharmacology. 62 (4): 463–471. doi:10.1002/jcph.1995. PMID   34708874. S2CID   240072663.
  3. ↑ Illingworth BJ, Lewis DJ, Lambarth AT, Stocking K, Duffy JM, Jelen LA, Rucker JJ (May 2021). "A comparison of MDMA-assisted psychotherapy to non-assisted psychotherapy in treatment-resistant PTSD: A systematic review and meta-analysis". Journal of Psychopharmacology. 35 (5): 501–511. doi:10.1177/0269881120965915. PMID   33345689. S2CID   229341150.
  4. 1 2 Pitts EG, Curry DW, Hampshire KN, Young MB, Howell LL (February 2018). "(±)-MDMA and its enantiomers: potential therapeutic advantages of R(-)-MDMA". Psychopharmacology. 235 (2): 377–392. doi:10.1007/s00213-017-4812-5. PMID   29248945. S2CID   3343930.
  5. 1 2 Burns J. "FDA Designates MDMA As 'Breakthrough Therapy' For Post-Traumatic Stress". Forbes. Retrieved 2019-07-19.
  6. 1 2 Danforth, Alicia L.; Grob, Charles S.; Struble, Christopher; Feduccia, Allison A.; Walker, Nick; Jerome, Lisa; Yazar-Klosinski, Berra; Emerson, Amy (2018-09-08). "Reduction in social anxiety after MDMA-assisted psychotherapy with autistic adults: a randomized, double-blind, placebo-controlled pilot study". Psychopharmacology. 235 (11): 3137–3148. doi: 10.1007/s00213-018-5010-9 . ISSN   0033-3158. PMC   6208958 . PMID   30196397.
  7. 1 2 Sessa, Ben; Higbed, Laurie; O’Brien, Steve; Durant, Claire; Sakal, Chloe; Titheradge, Daniel; Williams, Tim M; Rose-Morris, Anna; Brew-Girard, Elsa; Burrows, Sam; Wiseman, Chantelle; Wilson, Sue; Rickard, James; Nutt, David J (April 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. doi:10.1177/0269881121991792. hdl: 1983/c6e45e6e-b556-4a87-827b-6b3f4adfea7c . ISSN   0269-8811. PMID   33601929. S2CID   231963534.
  8. 1 2 Wolfson, Philip E.; Andries, Julane; Feduccia, Allison A.; Jerome, Lisa; Wang, Julie B.; Williams, Emily; Carlin, Shannon C.; Sola, Evan; Hamilton, Scott; Yazar-Klosinski, Berra; Emerson, Amy; Mithoefer, Michael C.; Doblin, Rick (2020-11-24). "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. Bibcode:2020NatSR..1020442W. doi: 10.1038/s41598-020-75706-1 . ISSN   2045-2322. PMC   7686344 . PMID   33235285.
  9. 1 2 3 4 5 6 7 8 Parrott AC (2014). "The potential dangers of using MDMA for psychotherapy". Journal of Psychoactive Drugs. 46 (1): 37–43. doi:10.1080/02791072.2014.873690. PMID   24830184. S2CID   23485480.
  10. 1 2 3 4 5 6 7 8 Morgan L (2020). "MDMA-assisted psychotherapy for people diagnosed with treatment-resistant PTSD: what it is and what it isn't". Annals of General Psychiatry. 19: 33. doi: 10.1186/s12991-020-00283-6 . PMC   7218633 . PMID   32435270.
  11. 1 2 Solon O (2016-09-16). "'My therapist gave me a pill': can MDMA help cure trauma?". The Guardian. ISSN   0261-3077 . Retrieved 2019-05-14.
  12. 1 2 Karlsen SN, Spigset O, Slørdal L (January 2008). "The dark side of ecstasy: neuropsychiatric symptoms after exposure to 3,4-methylenedioxymethamphetamine". Basic & Clinical Pharmacology & Toxicology. 102 (1): 15–24. doi:10.1111/j.1742-7843.2007.00159.x. PMID   18047478.
  13. ↑ Straud, Casey L.; Siev, Jedidiah; Messer, Stephen; Zalta, Alyson K. (Oct 2019). "Examining military population and trauma type as moderators of treatment outcome for first-line psychotherapies for PTSD: A meta-analysis". Journal of Anxiety Disorders. 67: 102133. doi:10.1016/j.janxdis.2019.102133. ISSN   1873-7897. PMC   6739153 . PMID   31472332.
  14. 1 2 3 4 Thal SB, Lommen MJ (2018). "Current Perspective on MDMA-Assisted Psychotherapy for Posttraumatic Stress Disorder". Journal of Contemporary Psychotherapy. 48 (2): 99–108. doi:10.1007/s10879-017-9379-2. PMC   5917000 . PMID   29720767.
  15. ↑ Ponte, Linnae; Jerome, Lisa; Hamilton, Scott; Mithoefer, Michael C.; Yazar-Klosinski, Berra B.; Vermetten, Eric; Feduccia, Allison A. (August 2021). "Sleep Quality Improvements After MDMA-Assisted Psychotherapy for the Treatment of Posttraumatic Stress Disorder". Journal of Traumatic Stress . 34 (4): 851–863. doi:10.1002/jts.22696. ISSN   0894-9867. PMC   8453707 . PMID   34114250.
  16. ↑ Tedesco S, Gajaram G, Chida S, Ahmad A, Pentak M, Kelada M, et al. (May 2021). "The Efficacy of MDMA (3,4-Methylenedioxymethamphetamine) for Post-traumatic Stress Disorder in Humans: A Systematic Review and Meta-Analysis". Cureus. 13 (5): e15070. doi: 10.7759/cureus.15070 . PMC   8207489 . PMID   34150406.
  17. ↑ Mitchell JM, Bogenschutz M, Lilienstein A, Harrison C, Kleiman S, Parker-Guilbert K, et al. (June 2021). "MDMA-assisted therapy for severe PTSD: a randomized, double-blind, placebo-controlled phase 3 study". Nature Medicine. 27 (6): 1025–1033. doi: 10.1038/s41591-021-01336-3 . PMC   8205851 . PMID   33972795.
  18. ↑ Burke MJ, Blumberger DM (October 2021). "Caution at psychiatry's psychedelic frontier". Nature Medicine. 27 (10): 1687–1688. doi:10.1038/s41591-021-01524-1. PMID   34635858. S2CID   238635462.
  19. ↑ Muthukumaraswamy SD, Forsyth A, Lumley T (September 2021). "Blinding and expectancy confounds in psychedelic randomized controlled trials". Expert Review of Clinical Pharmacology. 14 (9): 1133–1152. doi:10.1080/17512433.2021.1933434. ISSN   1751-2433. PMID   34038314. S2CID   235215630.
  20. ↑ Halvorsen JØ, Naudet F, Cristea IA (October 2021). "Challenges with benchmarking of MDMA-assisted psychotherapy" (PDF). Nature Medicine. 27 (10): 1689–1690. doi:10.1038/s41591-021-01525-0. PMID   34635857. S2CID   238636360.
  21. ↑ Kvam, Tor-Morten; Goksøyr, Ivar W.; Stewart, Lowan H.; Repantis, Dimitris; Røssberg, Jan Ivar; Andreassen, Ole A. (2022). "Study protocol for "MDMA-assisted therapy as a treatment for major depressive disorder: A proof of principle study"". Frontiers in Psychiatry. 13: 954388. doi: 10.3389/fpsyt.2022.954388 . ISSN   1664-0640. PMC   9645093 . PMID   36386973.
  22. ↑ Kirsch P, Esslinger C, Chen Q, Mier D, Lis S, Siddhanti S, et al. (December 2005). "Oxytocin modulates neural circuitry for social cognition and fear in humans". The Journal of Neuroscience. 25 (49): 11489–11493. doi:10.1523/JNEUROSCI.3984-05.2005. PMC   6725903 . PMID   16339042.
  23. ↑ Kamilar-Britt P, Bedi G (October 2015). "The prosocial effects of 3,4-methylenedioxymethamphetamine (MDMA): Controlled studies in humans and laboratory animals". Neuroscience and Biobehavioral Reviews. 57: 433–446. doi:10.1016/j.neubiorev.2015.08.016. PMC   4678620 . PMID   26408071.
  24. ↑ Gangopadhyay P, Chawla M, Dal Monte O, Chang SW (January 2021). "Prefrontal-amygdala circuits in social decision-making". Nature Neuroscience. 24 (1): 5–18. doi:10.1038/s41593-020-00738-9. PMC   7899743 . PMID   33169032.
  25. 1 2 3 4 Sessa B, Higbed L, Nutt D (2019). "A Review of 3,4-methylenedioxymethamphetamine (MDMA)-Assisted Psychotherapy". Frontiers in Psychiatry. 10: 138. doi: 10.3389/fpsyt.2019.00138 . PMC   6435835 . PMID   30949077.
  26. ↑ Sessa B, Higbed L, Nutt D (2019). "A Review of 3,4-methylenedioxymethamphetamine (MDMA)-Assisted Psychotherapy". Frontiers in Psychiatry. 10: 138. doi: 10.3389/fpsyt.2019.00138 . PMC   6435835 . PMID   30949077.
  27. 1 2 Colliver, Victoria (2023-09-18). "MDMA's Latest Trial Results Offer Hope for Patients with PTSD | UC San Francisco". www.ucsf.edu. Retrieved 2023-11-06.
  28. ↑ Carpenter, David E. "Australia The First Nation To Approve The Legal Use Of MDMA And Psilocybin". Forbes. Retrieved 2023-11-13.
  29. ↑ "Ecstasy 'too child-friendly' as deaths rise to record levels". BBC News. 2019-08-15. Retrieved 2020-10-22.
This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.