According to recent research, MDMA-assisted psychotherapy may help eliminate symptoms of post-traumatic stress disorder (PTSD) — as well as the condition itself.
Psychedelic-assisted therapy is gaining recognition as a potential healing modality in the mental health space.
Of the psychedelic substances currently being studied for therapeutic uses, MDMA shows strong evidence for treating mental health conditions, including post-traumatic stress disorder (PTSD).
“Increasingly, we’re seeing clinical evidence that shows MDMA-assisted therapy is effective,” says Payton Nyquvest, founder and CEO of Numinus, a company empowering healing via innovations around safe, evidence-based psychedelic-assisted therapies.
MDMA-assisted therapy received “breakthrough therapy” status from the US Food and Drug Administration (FDA) in 2017. “This means that early data showed promise above and beyond all other existing therapies,” Nyquvest explains.
Research from 2018 indicates that MDMA may help the brain process fear, which could allow fearful memories of traumatic events to be “re-written.”
According to Nyquvest, re-processing trauma with MDMA-assisted therapy might aid in releasing other emotions associated with post-traumatic stress disorder (PTSD), like grief and shame.
“MDMA works by creating a sense of safety and connection with the therapist(s), which may enhance therapeutic processing of traumatic events from the past,” explains Nyquvest.
He notes that the presence and skill of a trained therapist is key to positive treatment outcomes.
Easing PTSD symptoms
For some people, PTSD can significantly disrupt functioning in daily life, as well as relationships.
Common PTSD symptoms include:
- intrusive memories, flashbacks, or nightmares
- panic attacks
- unhelpful emotions and cognitions
- difficulty concentrating
- dissociation as a “numbing” technique
- withdrawal from activities
- difficulty functioning in daily life and within relationships
MDMA may drastically help relieve PTSD symptoms. A
What’s more, participants included people with conditions commonly related to PTSD, such as:
MDMA-assisted therapy is an interdisciplinary treatment involving both medical and mental health clinicians, says Nyquvest.
MDMA therapy for PTSD is a patient-centered, empowering approach that takes a “significant departure and paradigm shift” from the current standard of mental healthcare, he explains.
Goals of MDMA therapy for PTSD
“The aim of this approach is to impart a foundational understanding that each person has an innate process that guides them toward healing, when provided with optimal conditions,” says Nyquvest.
Integration is essential, he explains. “MDMA can be thought of as a catalyst for change, but the therapy and other non-pharmacological aspects of the client’s mindset and their environment are the factors that truly support healing.”
What to expect
A “co-therapy” team of two trained therapists typically partner during MDMA-assisted treatment sessions to ensure safety for patients, therapists, and the therapeutic process, Nyquvest explains.
According to Nyquvest, the psychotherapeutic approach here is called “inner-directed therapy” where the mental health professionals are specially trained to create an environment that supports the inner healing process of the person receiving MDMA therapy.
MDMA therapy typically begins with a medical and psychological screening for safety and to assess whether this type of therapy is a good fit for you, followed by a rigorous informed consent process.
According to Nyquvest, two to three 90-minute preparatory sessions are often required before beginning MDMA-assisted therapy.
MDMA-assisted therapy is typically carried out by two therapists over two to three sessions in a supportive environment. Each session lasts 8 hours total and are separated by 2 to 4 weeks.
Music is often played during the sessions, and you’ll typically have enough space to move around or recline on a couch or chair.
Your therapist will likely conduct at least one 90-minute integration session following each MDMA-assisted session. There is also often a closing integration session after your last MDMA session.
While many conventional treatments help manage symptoms,
“Psychedelic-assisted therapy is intensive and intended to address the root causes of distress, rather than managing symptoms,” says Nyquvest. “This approach can help people move forward in their lives after treatment, rather than requiring chronic medical or psychological support.”
Compared to more mainstream methods, MDMA therapy is a short-term treatment. The substance is typically only administered for up to three sessions. But despite the relatively short process, MDMA therapy offers long-term benefits.
Medications for PTSD can mask symptoms, cause unwanted side effects, and require long-term dosage. Traditional PTSD therapy methods aren’t always helpful, either.
Conventional treatments for PTSD include:
- medications, including antidepressants, anti-anxiety prescriptions, and sleep aids
- prolonged exposure therapy
- eye movement desensitization and reprocessing (EMDR)
- cognitive processing therapy (CPT)
Considering precautions is always a good place to start before trying any new therapy methods.
MDMA therapy isn’t for everyone, and it’s a good idea to consult your doctor or therapist beforehand to ensure it’s a safe option for you.
It’s not safe to use MDMA for PTSD if you are pregnant or nursing.
MDMA for PTSD also isn’t recommended for people who have certain physical health conditions, such as:
- cardiovascular disease
- risk of dehydration
- elevated body temperature
People with certain mental health conditions should also avoid MDMA, including:
- psychotic disorders
- bipolar disorder
- dissociative identity disorder (DID)
- eating disorders with active purging
- major depressive disorder (MDD) with psychosis
- personality disorders
- current alcohol and substance use disorders
Using MDMA can be dangerous while taking certain medications, including:
- SSRIs, which can cause serotonin syndrome, a potentially fatal condition
- MAO inhibitor antidepressants
- drugs metabolized by the liver enzyme CYP2D6
- medications that inhibit the liver enzyme CYP2D6, such as certain antiretroviral meds
MDMA therapy may also cause potentially severe side effects, including:
- reduced or lack of appetite
- sleep disturbances
- increased blood pressure
- nystagmus (eye wobble, blurred vision)
- mydriasis (dilated pupils)
- panic attacks
- muscle tension
- blurred vision
- teeth grinding
- jaw tightness and clenching
- moderate potential for addiction or problematic use in non-medical settings
- dry mouth
- difficulty concentrating
- feeling cold
- restless leg syndrome
Psychedelic-assisted therapy isn’t legal throughout the United States right now, so accessibility is currently limited. But you may be able to try MDMA psychotherapy for PTSD by:
- going to mental health treatment centers that offer psychedelic therapy
- joining clinical trials
- consulting with a psychedelic-assisted psychotherapy (PAP) trained therapist
Recreational MDMA use isn’t legal, either. It’s important to use MDMA for healing purposes alongside the supervision and guidance of a trained professional.
“In the United States, given the advanced state of Phase 3 research by Multidisciplinary Association for Psychedelic Studies (MAPS), it’s anticipated that the FDA may reschedule MDMA by 2023 to make it available for therapy,” says Nyquevest. ”Though, that doesn’t mean the drug would be available for legal recreational use.”
Current research indicates that MDMA therapy can be an effective treatment for PTSD.
If you haven’t found relief from traditional treatment methods, like medication or psychotherapy, you may want to consider MDMA-assisted therapy as an alternative, if possible.
Before taking MDMA for PTSD, it’s a good idea to consider speaking with a doctor or mental health professional who’s PAP-trained to help you determine if this treatment option is right for you.