MDMA Can Be a Powerful Tool in a Therapeutic Setting
MDMA (3,4-methylenedioxymethamphetamine) was invented by the Merck pharmaceutical company in 1912. MDMA increases serotonin and causes the release of hormones — such as oxytocin and prolactin — associated with trust and bonding.
What Are The Effects of MDMA?
The subjective effects of MDMA create a productive psychological state that may enhance the therapeutic process.
The acute effects of MDMA may include:
- Increased feelings of empathy and compassion
- Enhanced abilities of communication and introspection
- Reduced feelings of fear
- Increased feelings of well-being
- Increased sociability and extroversion
- Increased interpersonal trust
- Altered states of consciousness
- Temporary increased in anxiety
How Does MDMA Work With The Brain?
The Potential to Heal
MDMA-assisted psychotherapy is a fundamentally different mode of treatment from the daily, chronic administration of antidepressants or other psychiatric medications. With many advantages over existing treatments, namely efficacy, tolerability, and duration of effects, MDMA-assisted psychotherapy has the potential to greatly impact the lives of millions who suffer from PTSD worldwide.
To learn more about MDMA, its use in clinical research, published data, pharmaceutical properties, safety profile, and history, please read the MAPS Investigator’s Brochure. The following is a paraphrased excerpt from pages 8 and 9 of the MAPS Investigator’s Brochure, 10th edition:
MDMA is a ring-substituted phenethylamine, also known as 3,4-methylenedioxy-N-methylamphetamine and N-methyl-3,4- methylenedioxyamphetamine. MDMA’s chemical formula is C11H15NO2. MDMA is structurally similar, but functionally distinct, from amphetamines. MDMA is a chiral molecule, MAPS uses racemic MDMA in the form of white crystalline powder compounded with inert material into capsules. The hydrochloride salt of MDMA is readily water soluble and once ionized is lipophilic. A substantial amount of data, both clinical and nonclinical, has been collected for over half a century of research on the physiological and psychological effects of MDMA in humans and animals. Estimates from animal data suggest a median lethal dose (LD50) in humans between 10 to 20 mg/kg. Due to a wide range of responses to identical milligram per kilogram (mg/kg) dosing, MAPS’ human trials use fixed doses equivalent to between 1 and 4 mg/kg (active doses in studies range from 75 mg to 225 mg). Onset of MDMA effects occurs 30 to 60 minutes after oral administration, peak effects appear 75 to 120 minutes post-drug, and duration of effects lasts from 3 to 6 hours, with most effects returning to baseline or near-baseline levels 6 hours after drug administration. The elimination half-life of active doses of MDMA is 8 to 9 hours. The pharmacokinetics of MDMA in humans has been characterized using oral doses of up to 150 mg MDMA. MDMA disposition in the body follows nonlinear pharmacokinetics.
MDMA is a triple monoamine reuptake inhibitor, and similar drugs in this class have been found to exert potent anti-depressant activity with a favorable safety profile in clinical trials. MDMA concomitantly promotes release, inhibits reuptake, and extends duration of serotonin, norepinephrine, and dopamine in the synaptic cleft to increase serotonergic, noradrenergic, and dopaminergic neurotransmission. MDMA has self-limiting subjective and physiological effects due to inhibitory activity on tryptophan hydroxylase, which prevents additional serotonin from being produced and released. This inhibition is reversible.
MDMA produces anxiolytic and prosocial effects through release of the monoaminergic neurotransmitters, with the greatest effect on serotonin, followed by norepinephrine and dopamine. MDMA has been shown to acutely decrease activity in the left amygdala and increase blood flow to the prefrontal cortex (PFC) in the brain. MDMA has also been found to increase serum levels of the neurohormones oxytocin and arginine vasopressin (AVP) in humans. Some studies in healthy volunteers suggest that MDMA increases trust and attenuates reactivity to threatening cues, which are at least partially associated with oxytocin release. The combined neurobiological effects of MDMA can increase compassion for self and others, reduce defenses and fear of emotional injury, and make unpleasant memories less disturbing while enhancing communication and capacity for introspection. These factors taken together can provide the opportunity for a corrective emotional experience in the context of psychotherapy. Many of the therapeutic effects of MDMA-assisted psychotherapy are evident within a short period of treatment, often after the initial session.
Increased feelings of interpersonal closeness, changes in social perception and reduced anxiety may make MDMA a suitable pharmacological adjunct to enhance psychotherapy for anxiety disorders, such as PTSD and social anxiety in autistic adults. MDMA may provide a much needed option in the treatment of PTSD and anxiety associated with other conditions. Published results from MAPS studies showed clinically and statistically significant improvements in PTSD severity. As of May 31, 2018, over 1500 individuals exposed to MDMA in controlled research settings (which includes 227 participants in MAPS-sponsored Phase 1 and Phase 2 studies), there have been no unexpected Serious Adverse Reactions to date and expected Serious Adverse Reactions have been rare and non-life threatening. As of the data cut-off, a single expected Serious Adverse Reaction (increased ventricular extrasystoles), has been reported in MAPS-sponsored clinical trials.