8 ms·

A new study urges trials of MDMA to treat anxiety in autistic adults

110 points by Hooke 11y ago

Moshe_Silnorin 11y ago
I was under the impression that it is quite neurotoxic. Wikipedia seems to be backing me up here. Is this not the case?
- Alex3917 11y ago
  Not entirely accurate. MDMA does cause certain permanent neurological changes. However, at therapeutic doses/regimines, there aren't any behavioral deficits that result from those neurological changes. There are also certain things you can do to decrease neurotoxicity.
- code_reuse 11y ago
  You were under a false impression if you're referring to a single recreational dose (approx 120mg) taken once or even twice a weekend. The studies on animals that are often pointed to in Wikipedia involve exposing lab animals to doses that are both quite high and importantly far more frequent than the way this drug would utilized during sessions or as a party drug. Controlled tests on lab animals where a more normal dose was given and a more appropriate period of time was given between the next dose do not show any compelling evidence of any kind of long-term anomalies. The studies on humans that are often cited are typically unscientific because they're inclusive of individuals who also use other substances that are known to be neurotoxic such as alcohol or even methamphetamine. Also more importantly these recreational users are not given a supply of pure MDMA so it's safe to assume that some percentage of them are actually ingesting a cocktail of MDMA adulterated with other substances. With all of this said, the verdict is still out on whether or not this is neurotoxic in human at normal doses.. there definitely is a long term tolerance that builds up to the effect of the drug but this alone does not prove anything about neurotoxicity.
- dpatrick86 11y ago
  Also, one particularly notorious retracted study mixed up MDMA and meth... http://en.wikipedia.org/wiki/Retracted_article_on_dopaminergic_neurotoxicity_of_MDMA http://en.wikipedia.org/wiki/Retracted_article_on_dopaminerg...
- kirsebaer 11y ago
  A review by NIDA scientists explains that "neurotoxicity" arguments were based on overdosing animals, and that similar effects are seen with SSRI anti-depressants: Psychopharmacology (Berl). 2007 Jan;189(4):407-24. 3,4-Methylenedioxymethamphetamine (MDMA) neurotoxicity in rats: a reappraisal of past and present findings. Baumann MH, Wang X, Rothman RB. Free full-text: http://www.ncbi.nlm.nih.gov/pubmed/16541247 http://www.ncbi.nlm.nih.gov/pubmed/16541247 It has been previously claimed that overdoses of MDMA caused structural damage to serotonin axons ('axon pruning'), but there has never been any good evidence of this. Most evidence points to modulation of expression of serotonin transporters without damaging the axons themselves: The Nature of 3, 4-Methylenedioxymethamphetamine (MDMA)-Induced Serotonergic Dysfunction: Evidence for and Against the Neurodegeneration Hypothesis. Biezonski DK, Meyer JS. Curr Neuropharmacol. 2011 Mar;9(1):84-90. Free full-text: http://www.ncbi.nlm.nih.gov/pubmed/21886568 http://www.ncbi.nlm.nih.gov/pubmed/21886568
- sppooo 11y ago
  I took a fair amount of the stuff back in the 1980s -- at one point I estimated my cumulative total consumption as around 15 grams. (I'm sure there are people far beyond that now.) It is definitely neurotoxic -- I could tell that the first time I took it -- but in my experience, the noticeable effects are temporary, being mostly gone in a couple of weeks and quite undetectable after a couple of months. As a software developer who works in a fairly technical field, I'm quite sensitive to how well my brain is working on any given day. I did not notice any long-term falloff in my abilities as a result of MDMA use. All that said -- it does invite abuse, and I was abusing it. In 1990, my then-SO left me, and I realized I had to quit. I wouldn't worry about occasional, supervised, therapeutic MDMA use by healthy individuals.
  - deleted 11y ago
    [deleted]
  - Zer8 11y ago
    Same experience here. I took 0.1g to close to 1g on several occasions over a couple years. Doses in the 0.1-0.2g range would leave me fairly slow the next day, but that's it. With heavier doses I'd see after-effects for about a week (like reaching for my phone and pulling a lighter from my pocket, disconnecting in the middle of a conversation, losing track of time) The only time it took a long time to fully recover (5-6 weeks, progressively) was after taking some twice in 2 consecutive days. Quantities weren't big, maybe 0.5g total, but the effects lasted really long.
    - dzhiurgis 11y ago
      1 gram is an oversose. I did that twice and was getting vertigo for a week after. Same with my friends. I'd say fair amount per night is 2x0.1 grams per night.
travjones 11y ago
Using the term "autistic" is no longer acceptable. People-centered language is preferred (e.g., "individuals diagnosed with autism").
- phaus 11y ago
  I'm autistic and I'd rather people call me what I am than have to deal with pretentious, SJW-inspired nonsense like this.
  - Hytosys 11y ago
    Person-first terminology has been under debate since the 1990s[1][2]. The consensus among professionals (I just now spoke with a clinical psychologist Ph.D student who specializes in ASD research) is to use "individual with ASD/autism". Academia disagrees with you[3]. To be clear, if you would like to be referred to as an "autistic person", no one should have a problem with that. Similarly, you should not have a problem with the majority of people with autism preferring "person with autism". This means you should stop referring to this language as "pretentious, SJW-inspired nonsense". [1] https://www.questia.com/library/journal/1G1-16514166/person-first-disability-language-a-pilot-analysis https://www.questia.com/library/journal/1G1-16514166/person-... [2] https://aqr.uaa.alaska.edu/dss/information/upload/PeopleFirstLanguage-2.pdf https://aqr.uaa.alaska.edu/dss/information/upload/PeopleFirs... [3] http://aut.sagepub.com/content/early/2015/04/16/1362361315576221.abstract http://aut.sagepub.com/content/early/2015/04/16/136236131557...
    - Ollinson 11y ago
      This just sounds like another example of the euphemism treadmill.[0] Here's an interesting article from 5 years ago about a NYC agency with "retarded" in the name which refused to remove the word [1] The answer isn't as cut and dried as "professionals say so." [0]http://rationalwiki.org/wiki/Euphemism#Euphemism_treadmill http://rationalwiki.org/wiki/Euphemism#Euphemism_treadmill [1]http://www.nytimes.com/2010/06/08/nyregion/08name.html?_r=0 http://www.nytimes.com/2010/06/08/nyregion/08name.html?_r=0
ippster 11y ago
I can say, hands down, MDMA cured me from all and any social anxiety, it showed me that no-one gives a fuck, everybody is just the same and wants to be heard. Its so funny, every time links like this gets posted I just nod and think "Poor bastards, they haven't figured it out yet?" It's been 8 years since I did MDMA, so far no negatives as far as I can tell. Obviously, as with any strong drug/psychedelic, you will be a different person after the trip, what you take from that, is up to you. It is not for everybody, and especially if you feel you are prone to something like schizophrenia do NOT do psychedelics.
- WhitneyLand 11y ago
  First, are you saying you had social anxiety previously and that it was improved for the long term, without continued MDMA use? Secondly, what evidence is there that psychedelics cause schizophrenia?
  - ippster 11y ago
    First, yes, I had lots of problems navigating the social sphere, it was like there was some minor detail I just didn't understand, but which was crucial, it felt like it made me look and feel like a idiot. MDMA took all that away, it showed me that no, no one cares, just do your thing and don't bother. I did MDMA a few times during a year period. Second, NO, psychedelics absolutely do NOT cause schizophrenia in my opinion, BUT people who have underlying symptoms or are prone to it, for them it can very much act like a trigger.
    - WhitneyLand 11y ago
      What evidence is there that it can even be a trigger?
      - trendroid 11y ago
        Not sure why you were downvoted. I haven't seen much research on any other drug other than cannabis. Correlation(not causation) between its overuse and psychosis has been documented on several occasions[1][2]. But its good evidence only for people with already some form of genetic predisposition to get diseases like schizophrenia. So its 'triggering' in that sense. Of course more work is needed on such an important topic because there are contradictory studies like this one[3]. [1]http://www.sciencedirect.com/science/article/pii/092099649400053B http://www.sciencedirect.com/science/article/pii/09209964940... [2]http://europepmc.org/abstract/med/17007222 http://europepmc.org/abstract/med/17007222 [3]http://schizophreniabulletin.oxfordjournals.org/content/38/2/316.abstract http://schizophreniabulletin.oxfordjournals.org/content/38/2...
WhitneyLand 11y ago
It's exciting because it's such an intuitive hypothesis. People on the spectrum often have trouble reading emotions, people that use empathogens often feel enhanced abilities for similar tasks. Who knows if it will pan out, but it would change many directions in research.
deleted 11y ago
[deleted]
- deleted 11y ago
  [deleted]
FrankenPC 11y ago
If a medical researcher says that a chemical has potential benefit to alleviate suffering, then it's NOT up to politicians to decide if they can. Obviously, that's my opinion and it's not shared by American politicians.
- fapjacks 11y ago
  Ironically, Al Franken probably does share your opinion. :)
fapjacks 11y ago
I enrolled in the MDMA studies of veterans with PTSD. I have very high hopes for this substance as a medicine for a broad swath of afflictions.
M8 11y ago
Isn't treating autism same as treating homosexuality?
- syoc 11y ago
  No. EDIT: Hmm. If you are talking about things like aspergers and other "mild" autism diagnoses then I can see your point since I personally see them more as personalities. I don't see it as treating however I more see it as elevating downsides of an "autistic" personality.
- orik 11y ago
  the goal isn't too treat autism, but instead to treat anxiety in individuals with autism.
M8 11y ago
Isn't treating autism same as treating homosexuality?
samman 11y ago
Looking at the anecdotes being shared here, I see widely varying accounts of effects/efficacy. I wonder how many actually used 100% MDMA as opposed to one of its more 'designer' variants (blends, analogues, etc) generally available via illicit channels.
- tachyonbeam 11y ago
  There are many analogs being passed off as MDMA. However, it's normal that a given drug won't affect everyone in the same way. I've had pure MDMA several times (tested). I've supplemented with 5-HTP and antioxidants, made sure to eat, and even then I've often had issues where it left me depressed and anxious for days afterwards. My friends, who never supplement, do not experience such a crash. At this point, I generally avoid MDMA because the crash is too painful to be worth it. I've recently had my genes sequenced and found out that I have a slow variant of the TPH2 gene. This gene encodes for the enzyme (tryptophan hydroxylase) which makes serotonin. It's normal that I have more aftereffects after MDMA use, because my brain is probably 2-5x slower at replenishing serotonin. No amount of supplementation will fix this, because tryptophan hydroxylase is the bottleneck. Brains are more unique than faces. Pretty much every protein involved with monoamines has multiple common genetic polymorphisms. You really shouldn't expect MDMA or any drug to have the exact same effect on everybody.

110 points by Hooke 11y ago

Moshe_Silnorin 11y ago

I was under the impression that it is quite neurotoxic. Wikipedia seems to be backing me up here. Is this not the case?

Alex3917 11y ago
Not entirely accurate. MDMA does cause certain permanent neurological changes. However, at therapeutic doses/regimines, there aren't any behavioral deficits that result from those neurological changes. There are also certain things you can do to decrease neurotoxicity.
code_reuse 11y ago
You were under a false impression if you're referring to a single recreational dose (approx 120mg) taken once or even twice a weekend. The studies on animals that are often pointed to in Wikipedia involve exposing lab animals to doses that are both quite high and importantly far more frequent than the way this drug would utilized during sessions or as a party drug. Controlled tests on lab animals where a more normal dose was given and a more appropriate period of time was given between the next dose do not show any compelling evidence of any kind of long-term anomalies. The studies on humans that are often cited are typically unscientific because they're inclusive of individuals who also use other substances that are known to be neurotoxic such as alcohol or even methamphetamine. Also more importantly these recreational users are not given a supply of pure MDMA so it's safe to assume that some percentage of them are actually ingesting a cocktail of MDMA adulterated with other substances. With all of this said, the verdict is still out on whether or not this is neurotoxic in human at normal doses.. there definitely is a long term tolerance that builds up to the effect of the drug but this alone does not prove anything about neurotoxicity.
dpatrick86 11y ago
Also, one particularly notorious retracted study mixed up MDMA and meth... http://en.wikipedia.org/wiki/Retracted_article_on_dopaminergic_neurotoxicity_of_MDMA http://en.wikipedia.org/wiki/Retracted_article_on_dopaminerg...
kirsebaer 11y ago
A review by NIDA scientists explains that "neurotoxicity" arguments were based on overdosing animals, and that similar effects are seen with SSRI anti-depressants: Psychopharmacology (Berl). 2007 Jan;189(4):407-24. 3,4-Methylenedioxymethamphetamine (MDMA) neurotoxicity in rats: a reappraisal of past and present findings. Baumann MH, Wang X, Rothman RB. Free full-text: http://www.ncbi.nlm.nih.gov/pubmed/16541247 http://www.ncbi.nlm.nih.gov/pubmed/16541247 It has been previously claimed that overdoses of MDMA caused structural damage to serotonin axons ('axon pruning'), but there has never been any good evidence of this. Most evidence points to modulation of expression of serotonin transporters without damaging the axons themselves: The Nature of 3, 4-Methylenedioxymethamphetamine (MDMA)-Induced Serotonergic Dysfunction: Evidence for and Against the Neurodegeneration Hypothesis. Biezonski DK, Meyer JS. Curr Neuropharmacol. 2011 Mar;9(1):84-90. Free full-text: http://www.ncbi.nlm.nih.gov/pubmed/21886568 http://www.ncbi.nlm.nih.gov/pubmed/21886568
sppooo 11y ago
I took a fair amount of the stuff back in the 1980s -- at one point I estimated my cumulative total consumption as around 15 grams. (I'm sure there are people far beyond that now.) It is definitely neurotoxic -- I could tell that the first time I took it -- but in my experience, the noticeable effects are temporary, being mostly gone in a couple of weeks and quite undetectable after a couple of months. As a software developer who works in a fairly technical field, I'm quite sensitive to how well my brain is working on any given day. I did not notice any long-term falloff in my abilities as a result of MDMA use. All that said -- it does invite abuse, and I was abusing it. In 1990, my then-SO left me, and I realized I had to quit. I wouldn't worry about occasional, supervised, therapeutic MDMA use by healthy individuals.
- deleted 11y ago
  [deleted]
- Zer8 11y ago
  Same experience here. I took 0.1g to close to 1g on several occasions over a couple years. Doses in the 0.1-0.2g range would leave me fairly slow the next day, but that's it. With heavier doses I'd see after-effects for about a week (like reaching for my phone and pulling a lighter from my pocket, disconnecting in the middle of a conversation, losing track of time) The only time it took a long time to fully recover (5-6 weeks, progressively) was after taking some twice in 2 consecutive days. Quantities weren't big, maybe 0.5g total, but the effects lasted really long.
  - dzhiurgis 11y ago
    1 gram is an oversose. I did that twice and was getting vertigo for a week after. Same with my friends. I'd say fair amount per night is 2x0.1 grams per night.

travjones 11y ago

Using the term "autistic" is no longer acceptable. People-centered language is preferred (e.g., "individuals diagnosed with autism").

phaus 11y ago
I'm autistic and I'd rather people call me what I am than have to deal with pretentious, SJW-inspired nonsense like this.
- Hytosys 11y ago
  Person-first terminology has been under debate since the 1990s[1][2]. The consensus among professionals (I just now spoke with a clinical psychologist Ph.D student who specializes in ASD research) is to use "individual with ASD/autism". Academia disagrees with you[3]. To be clear, if you would like to be referred to as an "autistic person", no one should have a problem with that. Similarly, you should not have a problem with the majority of people with autism preferring "person with autism". This means you should stop referring to this language as "pretentious, SJW-inspired nonsense". [1] https://www.questia.com/library/journal/1G1-16514166/person-first-disability-language-a-pilot-analysis https://www.questia.com/library/journal/1G1-16514166/person-... [2] https://aqr.uaa.alaska.edu/dss/information/upload/PeopleFirstLanguage-2.pdf https://aqr.uaa.alaska.edu/dss/information/upload/PeopleFirs... [3] http://aut.sagepub.com/content/early/2015/04/16/1362361315576221.abstract http://aut.sagepub.com/content/early/2015/04/16/136236131557...
  - Ollinson 11y ago
    This just sounds like another example of the euphemism treadmill.[0] Here's an interesting article from 5 years ago about a NYC agency with "retarded" in the name which refused to remove the word [1] The answer isn't as cut and dried as "professionals say so." [0]http://rationalwiki.org/wiki/Euphemism#Euphemism_treadmill http://rationalwiki.org/wiki/Euphemism#Euphemism_treadmill [1]http://www.nytimes.com/2010/06/08/nyregion/08name.html?_r=0 http://www.nytimes.com/2010/06/08/nyregion/08name.html?_r=0

ippster 11y ago

I can say, hands down, MDMA cured me from all and any social anxiety, it showed me that no-one gives a fuck, everybody is just the same and wants to be heard. Its so funny, every time links like this gets posted I just nod and think "Poor bastards, they haven't figured it out yet?" It's been 8 years since I did MDMA, so far no negatives as far as I can tell. Obviously, as with any strong drug/psychedelic, you will be a different person after the trip, what you take from that, is up to you. It is not for everybody, and especially if you feel you are prone to something like schizophrenia do NOT do psychedelics.

WhitneyLand 11y ago
First, are you saying you had social anxiety previously and that it was improved for the long term, without continued MDMA use? Secondly, what evidence is there that psychedelics cause schizophrenia?
- ippster 11y ago
  First, yes, I had lots of problems navigating the social sphere, it was like there was some minor detail I just didn't understand, but which was crucial, it felt like it made me look and feel like a idiot. MDMA took all that away, it showed me that no, no one cares, just do your thing and don't bother. I did MDMA a few times during a year period. Second, NO, psychedelics absolutely do NOT cause schizophrenia in my opinion, BUT people who have underlying symptoms or are prone to it, for them it can very much act like a trigger.
  - WhitneyLand 11y ago
    What evidence is there that it can even be a trigger?
    - trendroid 11y ago
      Not sure why you were downvoted. I haven't seen much research on any other drug other than cannabis. Correlation(not causation) between its overuse and psychosis has been documented on several occasions[1][2]. But its good evidence only for people with already some form of genetic predisposition to get diseases like schizophrenia. So its 'triggering' in that sense. Of course more work is needed on such an important topic because there are contradictory studies like this one[3]. [1]http://www.sciencedirect.com/science/article/pii/092099649400053B http://www.sciencedirect.com/science/article/pii/09209964940... [2]http://europepmc.org/abstract/med/17007222 http://europepmc.org/abstract/med/17007222 [3]http://schizophreniabulletin.oxfordjournals.org/content/38/2/316.abstract http://schizophreniabulletin.oxfordjournals.org/content/38/2...

WhitneyLand 11y ago

It's exciting because it's such an intuitive hypothesis. People on the spectrum often have trouble reading emotions, people that use empathogens often feel enhanced abilities for similar tasks. Who knows if it will pan out, but it would change many directions in research.

deleted 11y ago

[deleted]

deleted 11y ago
[deleted]

FrankenPC 11y ago

If a medical researcher says that a chemical has potential benefit to alleviate suffering, then it's NOT up to politicians to decide if they can. Obviously, that's my opinion and it's not shared by American politicians.

fapjacks 11y ago
Ironically, Al Franken probably does share your opinion. :)

fapjacks 11y ago

I enrolled in the MDMA studies of veterans with PTSD. I have very high hopes for this substance as a medicine for a broad swath of afflictions.

M8 11y ago

Isn't treating autism same as treating homosexuality?

syoc 11y ago
No. EDIT: Hmm. If you are talking about things like aspergers and other "mild" autism diagnoses then I can see your point since I personally see them more as personalities. I don't see it as treating however I more see it as elevating downsides of an "autistic" personality.
orik 11y ago
the goal isn't too treat autism, but instead to treat anxiety in individuals with autism.

M8 11y ago

Isn't treating autism same as treating homosexuality?

samman 11y ago

Looking at the anecdotes being shared here, I see widely varying accounts of effects/efficacy. I wonder how many actually used 100% MDMA as opposed to one of its more 'designer' variants (blends, analogues, etc) generally available via illicit channels.

tachyonbeam 11y ago
There are many analogs being passed off as MDMA. However, it's normal that a given drug won't affect everyone in the same way. I've had pure MDMA several times (tested). I've supplemented with 5-HTP and antioxidants, made sure to eat, and even then I've often had issues where it left me depressed and anxious for days afterwards. My friends, who never supplement, do not experience such a crash. At this point, I generally avoid MDMA because the crash is too painful to be worth it. I've recently had my genes sequenced and found out that I have a slow variant of the TPH2 gene. This gene encodes for the enzyme (tryptophan hydroxylase) which makes serotonin. It's normal that I have more aftereffects after MDMA use, because my brain is probably 2-5x slower at replenishing serotonin. No amount of supplementation will fix this, because tryptophan hydroxylase is the bottleneck. Brains are more unique than faces. Pretty much every protein involved with monoamines has multiple common genetic polymorphisms. You really shouldn't expect MDMA or any drug to have the exact same effect on everybody.