MDMA, also known as Ecstasy or Molly,
is the psychedelic that's the closest
to getting FDA approval
for treatment for PTSD.
But what is MDMA and what does it do?
That's what I'm talking about today.
I'm Dr. Tracey Marks, a psychiatrist,
and I make mental health education videos.
Psychedelics are the wave
of the future in psychiatry.
I've talked about psilocybin,
aptly called magic mushrooms,
because what they do for depression
is magical compared
to how traditional antidepressants work.
You can take a look at this video
for more on mushrooms
and I'll have the video
linked at the end of this one.
MDMA is equally as powerful,
especially for treating post-traumatic stress disorder,
also called PTSD.
The chemical name for MDMA
is three-four-methylenedioxymethamphetamine.
So yes, it's a stimulant similar
to Adderall and Methamphetamine,
but MDMA has hallucinogenic properties
whereas Adderall does not,
or it's not supposed to.
MDMA alters how you process emotions.
When you bring to mind a negative experience,
the MDMA says,
"Hold on, not so fast.
"Let's pause a minute to process this."
It helps you better experience positive emotions
like feeling safe or feeling more in control.
You can also better appreciate
that what happened was then
and this is now.
It's common for you to have
uncomfortable physical sensations
when you have your negative recall.
the MDMA opens your mind to experience
the physical sensations differently
and not see them as threatening.
How does it do this?
MDMA reduces your fear response
that's activated in your amygdala.
Another thing that MDMA does
is promote acceptance and empathy
for yourself and others.
Often, people who have experienced chronic trauma
or early childhood trauma
can develop a thinking style of self-blame,
not just for what happened in the past,
but for current situations.
There's a lot of self-loathing
and MDMA assisted therapy
can help expand your awareness
of your personal assets.
Like you're giving yourself a new valuation
and this valuation is based
on fresh, objective information
that is applied with self-compassion.
The chemical changes that occur in your brain
are getting elevated levels of oxytocin,
which you can think of
as an attachment or bonding hormone.
And you get increases in serotonin,
norepinephrine and dopamine.
The decrease in amygdala activation
allows people to be less afraid
of working through therapy
without becoming emotionally overwhelmed.
This all sounds really good,
so how is this going to happen?
The Multidisciplinary Association for Psychedelic Studies
has been studying MDMA for 20 years.
They were initially granted FDA approval
to research it in 2001.
It took time to raise money for research
and in 2020,
they completed their Phase Three clinical trial
for using MDMA assisted psychotherapy for PTSD.
Phase Three is the last testing phase
Before the company submits an application
to the FDA for approval.
I've seen estimates
that they planned to submit
the application in 2023.
What did the study look like?
In the study,
participants took a dose of MDMA
and stayed overnight to be observed.
Then they had three
90 minute therapy sessions separated by days.
They repeated that cycle twice
for a total of three doses of MDMA
and nine follow-up therapy sessions.
The results of the study were remarkable.
Two-thirds of the participants who took MDMA
no longer met the criteria for PTSD
and these were people
who were considered treatment resistant
with PTSD for an average of 14 years.
That's pretty impressive
given that PTSD responds best
when it's fresh.
It's harder to treat,
but still possible to treat,
but harder to treat when you suffer with it
for many years.
Many of the participants also had depression
with their PTSD
and their depression also improved.
One of the very troubling symptoms of PTSD
is reliving the traumatic experience
or being unable to control
the memories intruding into your thoughts
even when you're not intentionally
thinking about them.
Part of the usual coping process
is to avoid thinking
about what happened,
but with trauma memories,
suppressing the thoughts
or running away from them
doesn't make them go away.
So as effective as trauma therapy is,
many people will not want to do it
because they don't want to deal
with the upsetting experience
of having to rehash what happened
or even being reminded
of things that they worked hard to forget.
This is where MDMA assisted therapy
can come to the rescue
and help facilitate proper emotional processing
of the traumatic experience
in a way that you can tolerate revisiting it
and have your brain reprocess it
so it's no longer traumatic for you.
So now we have to wait
until this drug is approved.
Why not just use
what's already available on the street?
Well, first of all, it's illegal.
But even if you get your hands on it,
there's a good chance
that what you take is cut with another agent
and is not 100% MDMA.
You don't have to believe me.
You can take a look at the site drugsdata.org.
I'll have it linked in the description.
This site publishes laboratory tested samples
from various sources.
It gives you a picture of the pill
and where it came from.
It also gives you a breakdown
of what agents were found
in the sample.
If we take a quick peek,
you can see data from 2022.
Out of the 2,400 samples,
only 554 were exclusively MDMA.
106 of the samples had no MDMA,
even though it was sold as MDMA.
And this bottom category is pills
that were sold as something else,
but really contained MDMA.
If you drill down on some of the lists,
you can see that common agents use to mix
with the ecstasy are caffeine, cocaine,
and other stimulants and ketamine.
So using street ecstasy
doesn't produce the same
controlled experience
you get with prescription MDMA
given in conjunction with psychotherapy.
Even if you take the good stuff,
the drug makes the chemical changes
that opens your mind,
but you still need guidance
with how to use that open mind
to change ingrained patterns of thinking.
So just taking MDMA alone
doesn't produce the same results.
We still don't know what this approval,
when it comes, will look like
since the study was based on
taking the drug along
with getting manualized therapy.
I suspect that the rules around it
will be similar to ketamine
where the clinician
has to get certified
to deliver the treatment
and show that they have training
to deliver the therapy,
or have someone in-house to do the therapy.
I guess that may be what's taking a while
to get the approval.
But either way,
it's exciting to have
another novel drug available.
Also, the acceptance of another psychedelic
opens the door to more
to be used therapeutically.
For more on psilocybin,
take a look at this video.
I'm researching doing another mushroom video
based on an article I read about mushrooms
possibly being able
to reverse personality disorders.
That's huge.
Personality disorders have always been something
that is seen as only slightly
to moderately changeable
with tons of therapy.
To have a drug that can erase
all the bad stuff
and help us all get along,
that's like multiverse stuff.
But I'm looking into it.
Stay tuned.
See you next time.