MDMA heads to Phase 3 trials for helping PTSD
A new study shows success in a series of Phase 2 trials.
- A new study in Psychopharmacology shows MDMA has a 50 percent efficacy rate for PTSD victims.
- A series of six controlled, double-blind studies moves research to Phase 3 trials.
- Combined with psychotherapy, MDMA could be a potent force in treating one of the our most challenging problems.
Over 8 percent of Americans will suffer from post traumatic stress disorder (PTSD) at some point in their lives, which is double the global average. Considering the current world population, that means roughly 308 million people will experience short-term or chronic PTSD from a variety of triggers: war, sexual assault, bullying — an entire list of invasive assaults. We're simply not equipped to handle such cognitive and emotional overload.
Which is why treatments are so badly needed. Last year, the Multidisciplinary Association for Psychedelic Studies (MAPS) published a study in The Lancet Psychiatry showing a 68 percent efficacy rate in PTSD symptom reduction; patients in that trial no longer needed ongoing treatment. It was another step on a decades-long battle to remove MDMA from Schedule 1 by proving its therapeutic value.
Now a new study, this one published in Psychopharmacology on May 7, combines the research of six Phase 2 studies on MDMA in order to move the research onto Phase 3. The tortoise-like approach that MAPS has taken since its 1986 founding has been critically important in opening a dialogue about the value of psychedelics. Of course, governmental oversight of these substances has not exactly been progressive.
But there is forward movement. As Michael Pollan notes in his opus on this topic, How to Change Your Mind, given the lack of continual efficacy and troublesome side effects of current pharmacological treatments, governmental agencies are now taking a hands-off approach to substances like psilocybin and MDMA. In fact, research is being requested.
How MDMA and psychedelic drugs can assist mental health
"I… learned about the unique effects of MDMA and why it was used in couple's therapy prior to being placed on Schedule 1 list. Using a drug only a few times to enhance therapeutic processing to resolve underlying issues that cause PTSD symptoms seemed like an approach worth investigating."
MDMA increases the amount of serotonin, dopamine, and noradrenaline neurotransmitters in certain regions of the brain. Though ecstasy became victim to a bad public image in the '90s for being associated with kids at raves not drinking enough water while dancing all evening, little attention was paid to dosage and environment. As with many mind-altering substances, fear mongering usurped a levelheaded, rigorous clinical approach to better understanding how these drugs can benefit us.
The six trials included in this study were conducted between 2004–2017. A total of 103 volunteers took part. Participants underwent two or three 90-minute psychotherapy sessions prior to ingesting MDMA to establish a baseline for their conditions. This was followed by two to three supervised MDMA (or placebo) sessions. Volunteers remained overnight; a 90-minute "integration" session followed.
In total, half of the volunteers no longer met the clinical criteria for PTSD after their MDMA sessions. This is compared to 23 percent in the placebo group. This remained true after a year of follow-ups, which is especially important given that many pharmaceutical treatments require daily usage to remain effective.
Researchers are not certain why substances in the serotonin-producing family "reboot" people's psychological condition. One speculative idea is perspective. For example, LSD has shown efficacy in treating addiction issues. While on the psychedelic journey, a new worldview is introduced. When the subjects realize how their addictions destroy their bodies, they vow to change after the journey is over. Something about the realization coupled with neurochemistry makes the changes stick.
Photo by Travis Dove for The Washington Post via Getty Images
A dose of MDMA in the office of Dr. Michael Mithoefer, a psychiatrist, who has studied the use of MDMA as a treatment for PTSD in Mount Pleasant, SC, USA on August 24, 2017.
For some reason, psychedelics offer, at least in parts of the population, a "wake-up" powerful enough to reorient their relationship to reality. MDMA appears to have a similar function: experiencing the "bliss" associated with the substance, volunteers integrate the experience deeply enough to shift their outlook. The trauma of the past no longer holds as much power over them.
How this correlates on a neurochemical level remains to be seen. Yet as the study authors note, the efficacy of these Phase 2 trials is dependent upon MDMA and psychotherapy. Taking the substance but not being offered professional guidance might not prove as effective in long-term integration regardless of chemical interactions. As has long been espoused in the psychedelic community, set and setting are equally important factors in the experience; drugs alone will not do the trick.
Minor side effects were recorded during the sessions, including anxiety, dizziness, jaw clenching, nausea, and lack of appetite. Still, given the overwhelming and profound nature of the experience, the team notes that MDMA has "a low potential for abuse." None of the volunteers reported craving more; a number of respondents said they did not find pleasure, and that it was "rather difficult therapeutic work delving into their traumatic memories."
As Feduccia says of the research, the road ahead is long. But this is an important step in overturning decades of misinformation about substances like MDMA and their therapeutic potential. If Phase 3 trials hold up, an entirely new — and more importantly, sanctioned — line of treatment could open up.
"It has taken many decades to reach this point for MDMA drug development," she says. "We are seeing a shift in public opinion as scientific evidence builds support for use of MDMA and psychedelics for treating mental health conditions. These are exciting times we live in, and could very well likely be on the cusp of a new paradigm for psychiatric medicine."
- Ecstasy as a Remedy for PTSD? You Probably Have Some Questions. ›
- Active ingredient in ecstasy may help veterans with PTSD, study finds ›
What can 3D printing do for medicine? The "sky is the limit," says Northwell Health researcher Dr. Todd Goldstein.
- Medical professionals are currently using 3D printers to create prosthetics and patient-specific organ models that doctors can use to prepare for surgery.
- Eventually, scientists hope to print patient-specific organs that can be transplanted safely into the human body.
- Northwell Health, New York State's largest health care provider, is pioneering 3D printing in medicine in three key ways.
Technology may soon grant us immortality, in a sense. Here's how.
- Through the Connectome Project we may soon be able to map the pathways of the entire human brain, including memories, and create computer programs that evoke the person the digitization is stemmed from.
- We age because errors build up in our cells — mitochondria to be exact.
- With CRISPR technology we may soon be able to edit out errors that build up as we age, and extend the human lifespan.
The controversial herbicide is everywhere, apparently.
- U.S. PIRG tested 20 beers and wines, including organics, and found Roundup's active ingredient in almost all of them.
- A jury on August 2018 awarded a non-Hodgkin's lymphoma victim $289 million in Roundup damages.
- Bayer/Monsanto says Roundup is totally safe. Others disagree.
The pizza giant Domino's partners with a Silicon Valley startup to start delivering pizza by robots.
- Domino's partnered with the Silicon Valley startup Nuro to have robot cars deliver pizza.
- The trial run will begin in Houston later this year.
- The robots will be half a regular car and will need to be unlocked by a PIN code.
Would you have to tip robots? You might be answering that question sooner than you think as Domino's is about to start using robots for delivering pizza. Later this year a fleet of self-driving robotic vehicles will be spreading the joy of pizza throughout the Houston area for the famous pizza manufacturer, using delivery cars made by the Silicon Valley startup Nuro.
The startup, founded by Google veterans, raised $940 million in February and has already been delivering groceries for Kroger around Houston. Partnering with the pizza juggernaut Domino's, which delivers close to 3 million pizzas a day, is another logical step for the expanding drone car business.
Kevin Vasconi of Domino's explained in a press release that they see these specially-designed robots as "a valuable partner in our autonomous vehicle journey," adding "The opportunity to bring our customers the choice of an unmanned delivery experience, and our operators an additional delivery solution during a busy store rush, is an important part of our autonomous vehicle testing."
How will they work exactly? Nuro explained in its own press release that this "opportunity to use Nuro's autonomous delivery" will be available for some of the customers who order online. Once they opt in, they'll be able to track the car via an app. When the vehicle gets to them, the customers will use a special PIN code to unlock the pizza compartment.
Nuro and its competitors Udelv and Robomart have been focusing specifically on developing such "last-mile product delivery" machines, reports Arstechnica. Their specially-made R1 vehicle is about half the size of a regular passenger car and doesn't offer any room for a driver. This makes it safer and lighter too, with less potential to cause harm in case of an accident. It also sticks to a fairly low speed of under 25 miles an hour and slams on the breaks at the first sign of trouble.
What also helps such robot cars is "geofencing" technology which confines them to a limited area surrounding the store.
For now, the cars are still tracked around the neighborhoods by human-driven vehicles, with monitors to make sure nothing goes haywire. But these "chase cars" should be phased out eventually, an important milestone in the evolution of your robot pizza drivers.
Check out how Nuro's vehicles work:
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