What if the solution to one of the most daunting psychological conditions were a party drug?
Post-traumatic stress disorder, or PTSD,
affects a huge portion of our population.
And while the treatments we use today vary,
at best they’re only about 50% effective.
But new research suggests
that people diagnosed with PTSD
can experience a lot of relief from an unconventional medicine.
And that medicine is MDMA.
[Intro]
People with PTSD often experience fear or stress,
even when they’re not in danger.
It can result from a range of previous experiences,
such as witnessing someone’s death or a physical assault.
If you experience PTSD,
you might be familiar with symptoms like flashbacks,
numbed emotional responses,
and sleep problems.
So this is one of those things
that can influence every aspect of your life.
But, despite its broad impact,
researchers aren’t totally sure what’s going on in your body to cause those symptoms.
One chemical that might hold some answers is oxytocin.
This is a molecule that regulates your anxiety and memories.
And rat studies suggest that when you’ve got a lot of it,
oxytocin mainly goes to the emotional center of your brain,
called the amygdala,
and decreases your fear and anxiety.
That means having a lot of oxytocin
is typically great because it keeps you calm.
And a study published in 2021 found that PTSD patients
had significantly less oxytocin than people without the condition.
The authors of that study suggested
that this could be a source of their stress,
although they acknowledged that it’s tough to measure this stuff,
so more research is needed.
Right now, we’re kind of in a chicken-or-egg situation
regarding the link between oxytocin and PTSD.
People who have a particular variety of oxytocin-related genes
might be at higher risk for PTSD. That predisposition is the egg.
And trauma can kick the enzyme that breaks down oxytocin into high gear.
The environmental factor is the chicken.
But both of those things could happen to the same person.
Some people might be unlucky enough
to have both the predisposition
for low oxytocin and traumatic experiences that set off PTSD.
And for people living with PTSD,
studies show that current treatments,
like selective serotonin reuptake inhibitors,
only work about half of the time.
Since PTSD is associated with low oxytocin levels,
one potential solution is to bump up your oxytocin.
But you can’t just give someone a shot of oxytocin
to get rid of their symptoms
because oxytocin has a hard time getting into the brain from outside.
It’s blocked by a group of cells called the blood-brain barrier.
And that’s where MDMA could help.
MDMA stimulates your brain cells to release more oxytocin.
So if you can’t give someone oxytocin,
you can get them to make their own using that drug.
Clinical studies have found that MDMA,
in combination with therapy,
is an effective treatment for PTSD.
And these were the most thorough tests we do.
They were placebo-controlled,
so half of the participants got MDMA
and the other half got a pill that didn’t do anything.
They were randomized,
so no selection went into who got MDMA and who didn’t.
They were double-blind, so neither the participants
nor the researchers knew who got MDMA during testing.
They were conducted in multiple testing sites,
so the results could be more broadly applicable to people in different places.
And they were phase 3 clinical trials,
so they’d already passed the basic research
and first two rounds of human studies.
After the trials,
most of the participants who had been given MDMA
weren’t even diagnosable as having PTSD anymore!
And several participants who hadn’t been able to work
due to their PTSD symptoms returned to work.
Another study followed up with participants
who had undergone a similar treatment
three years after being given the drug.
They found that the treatment continued to be effective. . . . .
Like, not from repeated use,
but rather long-lasting effects from the original trials.
In both of these studies,
MDMA was combined with therapy.
And therapy alone is helpful for many people with PTSD,
but became much more effective when the drug was added to the equation.
The researchers think that MDMA
is a helpful tool in combination with therapy
because it primes your brain for learning and change.
See, when we’re young, our brains are much more adaptable to taking
in new information and forging connections.
That’s called the critical period, because as we age,
we get less adaptable and that window of flexibility starts to close.
So that period of time is critical
to set up your brain for all of the things you do later in life.
And a study in mice found that MDMA
recalibrates sensitivity to stuff in their environment
by reopening that critical period.
Mice whose critical period had already closed were given MDMA,
and then started learning again like the younger mice
that were still in their critical period.
Another study built on this research, and while mice were in that adaptable state,
they essentially went through exposure-therapy
for a similar kind of learned fear that someone with PTSD might experience.
And those animals stopped showing PTSD-like responses!
They did more tests to figure out which parts of the brain
were involved in this treatment effect, and lo and behold,
the was more active after mice were treated with MDMA.
So to put it all together,
it seems that MDMA makes cells in the amygdala more active
and release more oxytocin,
which increases your brain’s adaptability
so that you can confront triggering experiences in a calmer state.
That makes it an incredible treatment option for people living with PTSD.
But if you don’t have PTSD
and you take MDMA recreationally with any regularity,
it might have very different effects.
MDMA keeps other chemicals in your brain,
like serotonin and dopamine,
from being cleared away and recycled.
The buildup of these chemicals can become toxic and damage your neurons.
So this stuff should only be used as advised by a medical professional.
But when used appropriately and in combination with traditional therapy,
studies show that MDMA can have incredible therapeutic effects
for people diagnosed with PTSD.
Not bad for a party drug.
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