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From its first use 3,4,-methylenedioxymethamphetamine (MDMA) has been recognised as a drug with therapeutic potential. Research on its clinical utility stopped when it entered the recreational drug scene but has slowly resurrected in the past decade. Currently there is enough evidence for MDMA to be removed from its Schedule 1 status of ‘no medical use’ and moved into Schedule 2 (alongside other misused but useful medicines such as heroin and amphetamine). Such a regulatory move would liberate its use as a medicine for patients experiencing severe mental illnesses such as treatment-resistant post-traumatic stress disorder.
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Ben Sessa, Psychatrist
13 March 2015
Dear Dr Rani Pathania,
Thank you for your supportive and informative words about the fascinating, important and exponentially developing field of MDMA ClinicalScience. This is a branch of research medicine that is now really taking off. You rightly allude to the recent work of Mithoefer (2010, 2013), whose long-term follow-up study showed a sustained absence of PTSD symptoms in 20 patients with treatment-resistant PTSD four years after a single course of MDMA-assisted psychotherapy.
MDMA Therapy research is now moving into Phase Three, with large multi-centre trials beginning within the next 24 months. (More details here: http://www.maps.org/research/mdma). This includes, we hope, a UK-based arm of the project and a planned licensing date for MDMA as a prescription medicine for treatment-resistant PTSD by the year 2021. Theseare bold steps indeed. For that large population of sufferers of PTSD who remain chronic and under-treated by traditional methods of treatment (almost 50% of all sufferers!) this cannot come soon enough.
Yours Sincerely
Dr Ben Sessa
References:
Mithoefer MC, Wagner MT, Mithoefer AT, Jerome L ,Doblin R (2010) The safety and efficacy of 3,4-methylenedioxymethamphetamine-assisted psychotherapy in subjects with chronic, treatment-resistant posttraumatic stress disorder: The first randomized controlled pilot study. J. Psychopharmacol. 25(4): 439-452
Mithoefer et al (2013) Durability of Improvement in PTSD Symptoms andabsence of harmful effects or drug dependency after MDM-assisted Psychotherapy: A Prospective Long-Term Follow-up Study. J Psychopharmacol,2013. 27:28-39.
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Conflict of interest: None declared
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Rani Pathania, doctor
06 February 2015
Amphetamine ,methylphenidate, Morphine ,heroin, ketamine are all potential drugs used clinically but whenever we hear the word "MDMA" -The first though that comes in our mind is Ecstasy and Rave parties ,people behaving in odd manner and experiencing hallucination, paranoia and disinhibition. Recently there has been lot of discussion on use of MDMA intreatment of resistant PTSD ,illness that is one the psychiatric illness that very difficult to treat and getting common these days because all horrific stuff happening around us . Studies like Mithoefer et al. (2010) {2012) have found that 83% of the subjects receiving MDMA-assisted psychotherapy in a pilot study no longer met the criteria for PTSD, and every patient who received a placebo and then went on to receive MDMA-assisted psychotherapy experienced significant and lasting improvements.We are still in initial stage and only few studies have been done but results of these studies are very significant. More research in this is needed and government needs to contribute by moving it to schedule 2 lists of drugs so that more researchcan be done in this field. At the same time one has to be very careful andvigilant to make these drugs legal for therapeutic use looking into dependence risk, effect on memory, depression and chances of psychosis. More research is needed especially to look at possible harms of the drugs.It will bring more responsibility on clinician to prescribe and monitor drugs like this.Making these drugs legal is not easy but at it has happened in the past otherwise people with terminal cancer will still be suffering with pain and agony in last days of their life, people with ADHD will be suffering despite being capable of doing everything.Legalising it for therapeutic use is not only going to be beneficial for patients but also going to be beneficial for economy looking into burden and resources we use in treating resistant PTSD.
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Conflict of interest: None declared
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