4 ms·

MDMA-assisted therapy for severe PTSD

10 points by sethbannon 5y ago

PragmaticPulp 5y ago
Brief warning about interpreting these studies: The primary treatment in these studies is the therapy, and the drug is only provided in limited sessions to augment the therapy. You cannot replicate these results by taking MDMA ad-hoc without the therapy. In this case, the study used 10 or more therapy sessions without MDMA. As a caveat, more members of the MDMA arm completed all therapy sessions, and the MDMA arm also had more patients opting for additional therapy sessions, which seems like a strange confounded to allow: > Additionally, 14 participants (10 of whom were in the MDMA arm) requested further integrative visits, as permitted by the protocol. The placebo group also scored significantly worse on 2 out of 3 measures of depression prior to starting the study, which is another strange discrepancy that can’t be dismissed. It’s good to see more studies in this area, but we need to be careful to not assume that drugs alone will fix these problems. Keep in mind that the therapy was significantly effective in the non-MDMA group as well. At least some of the difference between groups can be attributed to the starting differences between groups and the additional therapy received by the MDMA group.
IndySun 5y ago
For at least a couple of decades upwards of 250,000 people took MDMA every week, in the UK. During this period deaths solely from MDMA ranged from around 3 to 24 per year. How does that measure up to smoking, drinking, road traffic accidents? I too am not advocating for MDMA, but by any measurable standard, together with responsible, measured use, MDMA appears to be low risk and relatively safe, both physiologically and mentally. Some info here. https://www.drugwise.org.uk/how-many-people-have-died-from-ecstasy/ https://www.drugwise.org.uk/how-many-people-have-died-from-e...
- tdy_err 5y ago
  > low risk and relatively safe While the outcomes for victims is fantastic unfortunately, it is definitely with some risk: https://pubmed.ncbi.nlm.nih.gov/20420572 https://pubmed.ncbi.nlm.nih.gov/20420572 https://www.nature.com/articles/mp201397 https://www.nature.com/articles/mp201397 Death is an extreme negative outcome. Hamilton Morris makes a good point that if we view all chemicals by their mortality or OD potential then we are missing the big picture, and potentially demonizing medicine. But we should also look at non-deadly negative outcomes. Anecdotally, I suspect MDMA is quite psychologically addictive because it provides a once-in-a-lifetime serene feeling that can never be reproduced- once you use it, you will never experience it again as you did the first time. Moreover, the layman will try to overcome this by increasing dosage. Even responsible & informed adults may go against their better, rational, selves and reason about doing so on the basis of emotion.
  - IndySun 5y ago
    >I suspect MDMA is quite psychologically addictive MDMA consistently ranks particularly low when compared to alcohol, meth, cocaine, smoking.

10 points by sethbannon 5y ago

Brief warning about interpreting these studies: The primary treatment in these studies is the therapy, and the drug is only provided in limited sessions to augment the therapy. You cannot replicate these results by taking MDMA ad-hoc without the therapy. In this case, the study used 10 or more therapy sessions without MDMA. As a caveat, more members of the MDMA arm completed all therapy sessions, and the MDMA arm also had more patients opting for additional therapy sessions, which seems like a strange confounded to allow: > Additionally, 14 participants (10 of whom were in the MDMA arm) requested further integrative visits, as permitted by the protocol. The placebo group also scored significantly worse on 2 out of 3 measures of depression prior to starting the study, which is another strange discrepancy that can’t be dismissed. It’s good to see more studies in this area, but we need to be careful to not assume that drugs alone will fix these problems. Keep in mind that the therapy was significantly effective in the non-MDMA group as well. At least some of the difference between groups can be attributed to the starting differences between groups and the additional therapy received by the MDMA group.

IndySun 5y ago

For at least a couple of decades upwards of 250,000 people took MDMA every week, in the UK. During this period deaths solely from MDMA ranged from around 3 to 24 per year. How does that measure up to smoking, drinking, road traffic accidents? I too am not advocating for MDMA, but by any measurable standard, together with responsible, measured use, MDMA appears to be low risk and relatively safe, both physiologically and mentally. Some info here. https://www.drugwise.org.uk/how-many-people-have-died-from-ecstasy/ https://www.drugwise.org.uk/how-many-people-have-died-from-e...

tdy_err 5y ago
> low risk and relatively safe While the outcomes for victims is fantastic unfortunately, it is definitely with some risk: https://pubmed.ncbi.nlm.nih.gov/20420572 https://pubmed.ncbi.nlm.nih.gov/20420572 https://www.nature.com/articles/mp201397 https://www.nature.com/articles/mp201397 Death is an extreme negative outcome. Hamilton Morris makes a good point that if we view all chemicals by their mortality or OD potential then we are missing the big picture, and potentially demonizing medicine. But we should also look at non-deadly negative outcomes. Anecdotally, I suspect MDMA is quite psychologically addictive because it provides a once-in-a-lifetime serene feeling that can never be reproduced- once you use it, you will never experience it again as you did the first time. Moreover, the layman will try to overcome this by increasing dosage. Even responsible & informed adults may go against their better, rational, selves and reason about doing so on the basis of emotion.
- IndySun 5y ago
  >I suspect MDMA is quite psychologically addictive MDMA consistently ranks particularly low when compared to alcohol, meth, cocaine, smoking.