May is Mental Health Awareness Month and Microdose is doing its part to support mental health education with a series of informative articles and resources. Today, we look at MDMA therapy.
MDMA Therapy and MDMA-Assisted Psychotherapy
MDMA has been gaining attention for its potential therapeutic applications. In recent years, MDMA therapy, particularly MDMA-assisted psychotherapy, has been a topic of extensive research, with MAPS’ clinical trials using MDMA therapy for PTSD nearing completion and potential FDA approval.
MDMA-Assisted Psychotherapy
MDMA-assisted psychotherapy combines traditional psychotherapy with the administration of MDMA, a substance that can produce intense emotional empathy, increased energy, and heightened sensory perception. This therapeutic approach aims to help patients process difficult emotions and experiences more effectively by promoting trust, openness, and emotional connection with the therapist.
MDMA-assisted therapy sessions, as outlined by the Multidisciplinary Association for Psychedelic Studies (MAPS), run for several hours. In most cases, two therapists—a male-female pair when possible—facilitate the sessions, providing a nurturing and supportive environment. A session includes an MDMA administration period followed by an integration period. During the administration period, the patient may lie down, listen to music, and wear eyeshades, or engage in conversation with the therapists. The integration period involves discussing and processing experiences from the session. This setup is intended to promote therapeutic breakthroughs, safety, and comfort.
From MAPS’ Manual for MDMA-Assisted Psychotherapy in the Treatment of Posttraumatic Stress Disorder:
The basic premise of this treatment approach is that the therapeutic effect is not due simply to the physiological effects of the medicine; rather, it is the result of an interaction between the effects of the medicine, the therapeutic setting and the mindsets of the participant and the therapists.
MDMA produces an experience that appears to temporarily reduce fear, increase the range of positive emotions toward self and others, and increase interpersonal trust without clouding the sensorium or inhibiting access to emotions. MDMA may catalyze therapeutic processing by allowing participants to stay emotionally engaged while revisiting traumatic experiences without being overwhelmed by anxiety or other painful emotions. Frequently, participants are able to experience and express fear, anger, and grief as part of the therapeutic process with less likelihood of either feeling overwhelmed by these emotions or of avoiding them by dissociation or emotional numbing.
In addition, MDMA can enable a heightened state of empathic rapport that facilitates the therapeutic process and allows for a corrective experience of secure attachment and collaboration with the therapists.
Research participants have said that being able to successfully process painful emotions during MDMA-assisted psychotherapy has given them a template for feeling and expressing pain that has changed their relationship to their emotions.
MDMA Dosage
The appropriate dosage of MDMA varies based on factors like body weight, sensitivity, and desired effects. A common recreational dose ranges from 50 to 125 milligrams.
For therapeutic context, the MAPS MDMA therapy Phase 3 trials administered doses as follows:
In each experimental session the participants received a single divided dose of 80–180 mg MDMA or placebo. In the first experimental session, an initial dose of 80 mg was followed by a supplemental half-dose of 40 mg 1.5–2.5 h after the first dose. In the second and third experimental sessions, an initial dose of 120 mg was followed by a supplemental half-dose of 60 mg.
MDMA Therapy Results
Recent research has shown promising results for MDMA-assisted psychotherapy, particularly in the treatment of post-traumatic stress disorder (PTSD).
In 2021, MAPS published the first of its Phase 3 results and the outcomes were extremely positive. 88% of participants with severe PTSD experienced a clinically significant reduction in PTSD diagnostic scores two months after their third session of MDMA-assisted therapy, compared to 60% of placebo participants. Additionally, 67% of participants in the MDMA group compared to 32% of participants in the placebo group no longer met the criteria for PTSD two months after the sessions (source: MAPS)
In January 2023, MAPS announced that the second part of its Phase 3 trial of MDMA-assisted therapy for PTSD had confirmed prior positive trial results. MAPP2, the second Phase 3 trial of MDMA-assisted therapy, treated 104 participants living with PTSD with either MDMA-assisted therapy or placebo with therapy. The results confirmed findings from MAPP1; no serious adverse events were observed among the participants. The full data from MAPP2 is expected to be published in a peer-reviewed journal later this year and will support MAPS PBC’s new drug application to be filed with the U.S. Food and Drug Administration (FDA).
For a closer look at MAPS’ MDMA-assisted psychotherapy, check out the video below
And this video gives an overview of MDMA-assisted psychotherapy for PTSD
