A psychedelic drug could be a huge relief for people with severe PTSD

BODY & BRAIN Psychedelic drug eases severe PTSD

MDMA and talk therapy ousted the diagnosis in some people

BY LAURA SANDERS

The key ingredient in the illicit drug known as Ecstasy may offer profound relief from post-traumatic stress d isorder. When paired with intensive talk therapy, MDMA eased symptoms in people who had struggled with severe PTSD for years, researchers report in a new study.

“This is a big deal,” says clinical p sychologist Steven Gold, a professor emeritus at Nova Southeastern U niversity in Fort Lauderdale, Fla. “All other things being equal, the use of psych edelic medication can significantly improve the outcome.”

The preliminary findings, published May 10 in Nature Medicine, offer hope to the millions of people worldwide who have PTSD. Antidepressants such as Zoloft and Paxil are often prescribed, but the drugs don’t work for an estimated 40 to 60 percent of people with PTSD.

Ninety people participated in the new study, which took place at 15 c linical sites in the United States, Canada and Israel. All participants received 15 therapy sessions with therapists, all of whom were trained to guide people as they experienced the drug. Half of the participants received MDMA in three eight-hour s essions; the other half received placebos during three eight-hour sessions.

MDMA, true to its nickname Ecstasy, evokes feelings of bliss and social connectedness. The participants took the drug (or the placebo) while wearing eye covers and listening to music, and occasionally talking with their therapist about their experience.

On average, the participants improved by the end of the 18-week trial, showing fewer PTSD symptoms such as unwanted, intrusive memories. But the benefits were far greater for people who took the drug than for people who took a placebo. By the end of the trial, 67 p ercent of participants in the MDMA group had improved so much that they no longer qualified as having a PTSD diagnosis. Among participants in the placebo group, 32 percent no longer met the criteria for PTSD at the end of the study. Those evaluations came from independent clinicians who assessed participants without knowing who had taken the drug.

Many people in the trial had been l iving with severe PTSD for years. “Typically, we see PTSD as a disorder for life. Now, we may begin to let that go,” says Eric Vermetten, a psychiatrist at the Leiden University Medical Center in the Netherlands who works with veterans and members of the military with PTSD and was not involved in the study.

It’s not clear exactly how MDMA changes the brain. Some imaging studies suggest that the drug dampens a ctivity in the amygdala, a brain structure involved in fear. Other results from mice hint that MDMA may open a window of heightened social learning, a scenario that could strengthen the relationship between a patient and a therapist.

The new study included weeks of talk therapy. Those sessions took place before, during and after MDMA sessions. Talk therapy required hard emotional work from participants, says study coauthor Amy Emerson. MDMA “is not a magic pill,” she says. The study was funded by the nonprofit group M ultidisciplinary Association for P sychedelic Studies, or MAPS. E merson is the CEO of MAPS Public Benefit C orporation in San Jose, Calif., which organized the trial.

Over three-quarters of the participants in the trial were white. Without a more diverse group of people in such studies, it’s not clear whether therapy with MDMA would yield similar effects more generally, Gold says. Researchers are following the health of the participants in the new study to see whether the improvements last.

Another clinical trial comparing MDMA’s effects on PTSD symptoms with a placebo is in the works, Emerson says, as well as expanded use of MDMA in clinics.

For now, the research is complicated by restrictions on MDMA, which remains an illicit drug in the United States. “There are a lot of barriers to break down related to this treatment,” Emerson says. “And there’s a lot of hope.” s

Therapists work with a participant during a trial to determine if MDMA, the key ingredient in the drug Ecstasy, can ease symptoms of post-traumatic stress disorder. A majority of participants who received the drug no longer qualified for a PTSD diagnosis after the trial ended.