MDMA, the main ingredient of the party drug ecstasy, could help reduce symptoms among those living with post-traumatic stress disorder, research suggests.

Post-traumatic stress disorder is commonly treated with drugs, psychotherapies or both. However, some find little benefit, with certain talking therapies linked to high dropout rates.

Now scientists have released the latest of several small studies showing that MDMA, when combined with talking therapies, could prove effective in reducing symptoms.

“It is thought that the MDMA is catalysing the therapy, [rather than] just being effective on its own,” said Dr Allison Feduccia, co-author of the research by the MAPS Public Benefit Corporation, a US-based charity focused on research into MDMA and psychotherapy, which funded the study.

Feduccia added that MDMA affected levels of certain chemicals in the brain and helped individuals become more emotionally engaged in the therapy.

The study is one of six that has led the US Food and Drug Administration (FDA) to designate MDMA as a “breakthrough therapy” for PTSD and approve the next stage of clinical trials – so called “phase three”– which must be passed before the approach can be made available to patients. “We’re starting the first phase three trial [this month],” said Feduccia.



The research, published in the Lancet Psychiatry journal, involved 19 men and seven women with PTSD, including military veterans, firefighters and a police officer. They were randomly assigned to receive either 125mg, 75mg or 30mg of MDMA each month with participants and therapists unaware of the dose strength. The smallest dose was expected to have little therapeutic effect but offered a comparison for the higher doses.

Participants were given psychotherapy before the drug was administered, for eight hours immediately afterwards and in the weeks that followed.

The results reveal that one month after the second MDMA-psychotherapy session, participants taking the higher doses showed a significantly greater improvement in areas including severity of PTSD symptoms, sleep quality, certain personality traits and an ability to function in daily life, compared with those on the lowest dose.



Indeed, six of the seven participants assigned to take 75mg of the drug and seven of the 12 given 125mg no longer met the criteria for PTSD, compared with two of the seven participants given the 30mg dose.

Further work, in which participants were offered extra sessions with a 100-125mg dose, supported the idea that a certain level of MDMA is needed for large improvements from therapy to be seen.

The team say benefits persisted 12 months after the study began, with 16 of the 24 participants who completed the study no longer meeting the criteria for PTSD, among other improvements.

However, the study had a number of limitations, including its small size, lack of placebo, the fact that those on the lowest dose of MDMA could have been harder to treat and that a small number of participants took MDMA of their own accord before the final follow-up.



Although participants reported side-effects including anxiety, headaches and short-term increases in suicidal thoughts, experts say the treatment appears to be safe.

Philip Cowen, professor of psychopharmacology at the University of Oxford who co-wrote a commentary to the research, said it was notable that patients continued to do well 12 months after treatment began.



But he was cautious. “You wouldn’t say it is a step forward in a general sense yet, because you have to show that it is more widely applicable,” he added.

Cowen said that larger trials from other teams and including a broad range of participants were crucial, not least because the study involved volunteers keen to sign up. He also noted that the approach required intensive psychotherapy sessions and experts trained in working with people who have been given MDMA. This means it is unlikely to become part of regular NHS psychiatric services, according to Cowen, who stressed that individuals should not self-medicate with the drug. “MDMA here is just part of the treatment, there is a lot of psychotherapy going on,” he said.

But Prof David Nutt, director of the neuropsychopharmacology unit at Imperial College London who is working on the use of MDMA for alcoholism following trauma, called the research a very significant development. “It could revolutionise the treatment of PTSD, for which there has been almost no progress in the past 20 years,” he said.

• In the UK, Samaritans can be contacted on 116 123 or email jo@samaritans.org. You can contact the mental health charity Mind by calling 0300 123 3393 or visiting mind.org.uk