A Checkered Past: The Surprising Resurgence of MDMA as a Therapy Drug

Friday - September 22 2023, 02:41 UTC - 1 year ago

MDMA, known as "ecstasy" or "molly", has been gaining acceptance in the clinical realm as a viable therapy drug as clinical trials in many countries have shown its effectiveness against severe mental trauma, such as PTSD. Although it is still listed as a Schedule 1 drug by the DEA, scientists are increasingly seeing its potential in helping to combat difficult mental problems, with progress being made towards potential rescheduling. The drug has a long checkered past, as it was initially developed in 1912 for controlling bleeding, but was soon eyed by maverick researchers who saw its potential in couples' therapy.

MDMA doesn’t have the best reputation. Known as "ecstasy" or "molly," the drug is synonymous with rave culture: all-night electronic beats and choreographed laser shows.

Still, it may soon join the psychedelic drug resurgence—not for partying, but for tackling severe mental trauma, such as post-traumatic stress disorder (PTSD).

Last week, Nature Medicine reported a multi-site, randomized, double-blind trial in over 100 patients with PTSD. The drug, combined with therapy, was carefully administered to patients being monitored in doctors’ offices. Compared to patients given the same therapy with a placebo, MDMA was far more effective at dampening PTSD symptoms.

The study, led by the non-profit Multidisciplinary Association for Psychedelic Studies (MAPS), follows an earlier Phase 3 trial—the last stage of clinical testing before regulatory approval. In that trial, participants also received therapy. Roughly twice the number of people given MDMA rather than a placebo recovered from their PTSD diagnosis.

The new, long-awaited study bolsters those earlier results by recruiting a more diverse population and showing that the treatment worked across multiple racial and ethnic groups.

To be very clear: the trials are for MDMA-assisted therapy. The psychotherapy component is key. The team repeatedly warns against seeking out the drug and taking it without supervision.

"What we believe is that the results that we got were not from MDMA," said MAPS founder Rick Doblin to Nature in an earlier interview. "They were from highly trained therapists who are then using MDMA." .

The Food and Drug Administration generally requires two controlled trials before it considers approving a drug. MAPS has now delivered. The organization plans to seek approval this October. If the results hold up, the US may join Australia in welcoming a previously condemned drug as a new treatment for PTSD.

It won’t be an easy road. Although public and scientific opinions have shifted towards tolerance, MDMA is still listed as a Schedule 1 drug by the DEA. Drugs in this category are deemed to have "no currently accepted medical use and a high potential for abuse," placing them alongside heroin.

That said, scientists are increasingly taking psychedelics seriously as tools that can help combat difficult mental problems. Also among Schedule 1 drugs are cannabis, psylocibin (from magic mushrooms), and LSD (commonly known as acid). These illicit drugs are gradually being embraced both in the research and clinical spheres as valid candidates for further study.

To Dr. Amy Kruse at the venture capital firm Satori Neuro based in Maryland, who was not involved in either study, "MAPS has been the beacon to kind of take on this work…There are many people that can benefit from this treatment, and I think it shows a pathway for the potential rescheduling of other molecules." .

A Checkered Past .

MDMA—an acronym for its chemical name, 3,4-methylenedioxymethamphetamine—didn’t always wear the party drug black hat. It has enthralled psychiatrists since its birth in 1912.

Developed by a German pharmaceutical company to control bleeding, the drug soon caught the eye of maverick researchers. Some claimed the drug gave a boost to couples’ therapy, allowing the practitioner to “tweak the social behavior of subjects.” .