Medical science has made such tremendous progress that there is hardly a healthy human left. Aldous Huxley

Anxiety, sadness, helplessness, spiritual emptiness. All these are emotions which probably everybody of us experienced at certain points during our lifetimes. However, this does not rewrite rudimentarily the emotional disruption which PTSD-patients have to live through on a daily basis.

Posttraumatic stress disorder (PTSD) are psychic diseases which can be triggered by traumatizing events. These include abuse, sexual abuse, war experiences, heavy accidents, and other strong burdensome happenings. Already in harmless situations, people concerned are often heavily stressed, frightened or threatened. Typical symptoms are affective intolerance, avoidance attitude, and social isolation; also concentration and sleep disorders as well as nightmares or suicide are not uncommon.

As a result of their inability to resist heavy emotional states (affective intolerance) and also the consequent avoidance attitude towards the traumatizing experience and because of the social isolation it’s often very difficult to treat the people concerned. Especially patients who were abused by confidants are suspicious of other people, what makes an open relationship with the therapist significantly more difficult.

PTSD is a serious national health problem. Between 6 and 10 percent of the American population is suffering at least one time during their lifetimes from PTSD. The number of American soldiers who are returning from the war zone in Irak rose up to 18 percent and children who are living in war zones rose even more up to 41 percent. In more than a third of these cases, the patients are not recovering even after years of therapy.

Psychotherapeutic potential

MDMA alone is not a magic cure. Alone through the consumption of this particular substance any of the patients will be cured. Nevertheless, MDMA combined with a psychotherapy may lead to tremendous success in treatments of PTSD patients. With the assistance of MDMA supported psychotherapy, profound psychological changes can be achieved in a very short amount of time. Even with treatment-resistant patients, one single session with MDMA can cause enormous improvements.

After the first completed phase 2 study from MAPS (Multidisciplinary Association for Psychedelic Studies) 83 percent of the patients showed no PTSD-symptoms anymore after only two MDMA sessions. During these sessions there were no serious blood pressure increases and no neurocognitive effects noticed. In a long term follow up study there were at least 74 percent who showed no symptoms anymore.

Different than most antidepressants, MDMA is not taken on a daily basis. In the studies of MAPS the substance is administered only two to three times.

Each one of the eight hours MDMA sessions took place several weeks apart from the other, so that neurotoxic damage can be eliminated. Between, there are regular therapy sessions without any substance ingestion. The oral initial dosage given to the patients is either 100 or 125 milligrams. In special and optional cases the therapists administers a second dose of 50 or 62.5 milligrams (50 percent of the initial dose).

The neurophysiological effect of MDMA is mainly caused by the release and resumption inhibition of serotonin, dopamine, and noradrenaline as well as through the release of oxytocin and prolactin. Although MDMA shows noradrenergic and therefore stimulating active components, the main effect is less locomotor, but more entactogenic and empathogenic.

Because of the entactogenic effect of MDMA the concentration focussed on the personal emotional dimension (introspection) is simplified. PTSD patients are often suffering merciless self-judgment and an unconscious avoidance posture towards countless stimuli which are connected to the traumatic event. These can trigger the reactivation of the trauma.

Patients with chronic PTSD were found to have permanent change in cerebral structures. Especially affected are Amygdala, Hippocampus and the prefrontal cortex. These brain areas are among others involved in the emotional valuation of situations and processing of stress reactions. MDMA leads to change in the blood flow of Amygdala and Hippocampus which can be an explanation for stress reduction and emotional tolerance.

Psychological blockages can dissolve with the support of MDMA; through this process, patients are capable to face their traumatic memories and to deal way better with negative emotions. MDMA is also capable of raising one’s consciousness for the positive in the earthly life. This is achieved by inducing euphoria and feelings of security. Moreover, the experienced events can be remembered from a different perspective and therefore a processing is much easier. MDMA is intensifying the self-awareness and improves both self-esteem and self-acceptance. Through this, patients learn to accept their strengths and weaknesses and as a result, to find constructive solution approaches for their lives. We call this process the «inner healer». Additionally, to the psychological relief, MDMA is taking care of somatic muscle tension or pain.

Through the empathogenic effect of MDMA prosocial effects such as openness, trust towards other people and need for closeness are significantly enhanced. This way, a close and trustworthy relationship between patient and therapist is more likely to establish.

To take benefit from the entactogenic and empathogenic effects of MDMA, phases are changing during an MDMA session from inner peace to open communication with the therapist.

Typically, in cases of PTSD, it comes to uncontrollable and strong flashbacks (re-experiencing of traumatic events), but also to blackouts of causes of the trauma. MDMA enhances the access to the long-term memory whereby inaccessible traumatic memories can be processed.

Just as with the set and dosage the therapeutical setting for the MDMA session is of great meaning. Therefore, the treatment room has to be convenient and appealing as well as free of external distraction possibilities. The participant has to have a feeling of safety and privacy. However, it’s still possible that during the session the patient will get into phases of anxiety because of the changed body sensation and emotions coming up. Often this leads to the increased need for psychotherapeutic guidance during these particular sequences.

In order to have a long-term benefit of the treatment, the MDMA experiences need to be integrated into daily life. The first few days after the MDMA sessions can be filled with emotions like anger, sadness, anxiety, and others as well; this is part of the integration process and should not be interpreted as a worsening of the psychological disease. To support this process there are specific postprocessing sessions available to the patient.

Risks and therapy

As it’s the case with most medications, there are also some issues with MDMA. The substance increased the puls, blood pressure and body temperature, which is why pre-investigation regarding heart circulatory disorders and a observation of body temperature has to be done. As needs such as hunger and thirst are not really perceived anymore under the influence of MDMA, one must ensure the supply of water to reduce the risk of dehydration.

In recreational cases, the number of deaths caused only by MDMA decreased a lot and got uncommon. The most frequent causes of death are overdosage, polydrug use with other psychedelic substances or dangerous cutting agents. The MDMA used for medicinal cases is a pharmaceutical pure product which is administered in moderate dosage under supervision. In the recent clinical studies of MAPS, more than 1100 patients were treated and there were no unexpected side effects nor neurotoxic long-term consequences.

Considering the potential neurotoxicity and the potential of addiction to MDMA it frequently comes to criticism of MDMA supported psychotherapy. Fact is that MDMA consumption, when not approached with the safer use rule can lead to damages of the serotonergic system. But when you’re working with dosages adapted to the bodyweight and long distances of time, enough liquid supply and so on, MDMA is generally not toxic. Even MDMA shows a certain potential for addiction, most of the time it’s not coming to the formation of an addiction. Not even in cases of recreational usage. In therapeutical practice, the risk of addiction to MDMA is even progressively lower.

Prospects

Unfortunately, MDMA supported psychotherapy is still illegal and is only allowed with a special authorization for research purpose. This despite that risk-benefit-ratio is better than observed with other medications. MAPS’s about to start with the final phase-3-study. The study will determine, whether MDMA will get the approval as a medication for PTSD in the states. MAPS expects the medicinal approval at latest in the year 2021.

Also, other diseases could be treated with MDMA. Adult autistics with social anxiety disorder show an improvement in their social resilience and therefore anxiety symptoms when treated with MDMA supported psychotherapy.

Currently, there’s a study from MAPS which evaluates the benefits of treatments of patients with anxiety disorder caused by life-threatening diseases. Moreover, the Imperial College London under David Nutt is leading the worldwide first research for the treatment of alcohol addicts. The results of this study might bring insights how MDMA can be used in cases of people having addictions and psychological disorders. In addition, there are hints that MDMA can also be used in cases of bipolar disorders, cerebral locomotor disorder, chronic pain, depression, ovarian cyst, eating disorder, rheumatoid arthritis, trichotillomania, Tourette syndrome as well as family and couple therapies and neuromuscular therapy. Clinical studies are to be made.

Source: http://lucys-magazin.com/; Nr. 6

Disclaimer:

This article does not promote or recommend the use of illegal drugs. Many of the substances referenced to in the content are illegal in many countries. This article does not constitute medical advice. As always, please consult your doctor before taking any medicine.

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