'Party' Drug Could be PTSD Treatment

By chillinwill · Mar 4, 2009 · ·
  1. chillinwill
    If you discovered it in your kid’s room there’d be hell to pay. If it appeared in a random urinalysis, it could end your career. And if you told your friends you were considering taking it, they might think you’ve suffered a mid-life crisis.

    But a South Carolina psychiatrist and a Harvard-educated researcher are looking for veterans who’ve been through hell and are willing to explore a fresh way of getting past the trauma using a drug long associated with the late-night party crowd.

    Ecstasy, clinically known as MDMA and outlawed recreationally for decades, is making a gradual comeback in the medical community as therapists rediscover its therapeutic value – especially in dealing with post traumatic stress disorder.

    “I heard about it and I decided to give it a try,” said a former Army Ranger who was one of two veterans who participated in a recent study on the effects of Ecstasy for treating PTSD. “It’s an extremely positive thing. I feel so lucky that I got to take part in the project.

    “It’s basically like years of therapy in two or three hours. You can’t understand it until you’ve experienced it.”

    Michael Mithoefer, a former emergency room physician turned psychiatrist, and Rick Doblin, who founded an organization to study the role of psychedelic drugs in society, are lobbying the Department of Veterans Affairs to allow veterans suffering from PTSD to take part in their unconventional research.

    Mithoefer works with his wife, Ann, out of their Mount Pleasant, S.C., office helping victims of serious trauma overcome their anguish.

    With support from Doblin, the couple successfully petitioned the Food and Drug Administration to allow them to test the effects of the drug on people who suffered from PTSD. They recently completed their first round of testing, with promising results.

    “This is very exciting for us and I am very hopeful that other people can replicate the results,” Mithoefer said.

    “I have to stress that this is a lot different than getting a prescription for MDMA. We don’t see it ever working like that,” Mithoefer added. “You’ll have to take it in specialized clinics. No one will get to take it home.”

    In the latest round of testing, 21 patients took the drug a handful of times throughout an extended period of psychiatric treatment. It’s administered under a strict set of conditions and always under close supervision by medical professionals.

    Mithoefer and Doblin are not fly-by-night crackpots promising an overnight cure of a serious condition with a magic pill.

    “It’s been approved by the FDA and Harvard. We have evidence of its safety and evidence of its efficacy,” Doblin said. “We’ve shown that we can help Soldiers deal with their trauma.”

    Medical, military uses

    MDMA has an interesting history. Developed by the pharmaceutical firm Merck in 1912, it was widely used in private psychiatric settings in the 1950s and ‘60s. The Army experimented with it briefly in its search for mind control drugs, Doblin said.

    It induces feelings of extended euphoria -- hence the name ecstasy -- as well as heightened awareness and a greater connection to emotions.

    But it was embraced by the counter-culture of the late 1960s, and by the 1980s it was competing with cocaine as the most popular party drug. In 1985, the Drug Enforcement Administration had it classified as a “Schedule I” drug, alongside LSD and heroine.

    “It was really a shame because we were only beginning to understand its potential for medical treatment” when it was criminalized, Doblin said. “With drugs like this, there is a lot of misconception. … They are like the surgeon’s knife: If they are used properly, they can heal. If they are used poorly, they can kill.”

    The research project began with people suffering from PTSD who were victims of crime – rape and childhood sexual abuse were the most common – and only recently expanded to veterans.

    The former Army Ranger, who spoke to Military.com on the condition of anonymity because he continues to work for private military contractors, and a former Marine officer were the first veterans to participate.

    Both served in Iraq and suffered moderately severe PTSD – re-experiencing the initial trauma, sleeplessness, flashbacks and nightmares – before participating in the program.

    “I didn’t want to be part of this 'Prozac nation.' I know some of those people and they don’t feel up or down or anything all. They aren’t really living,” the former Ranger said.

    “I think it’s especially helpful for Soldiers, or someone who comes from a hard or tough background, because this is just the opposite,” the Ranger said. “It’s a soft, compassionate loving drug. You lie down, listen to some relaxing music and can really connect with your emotions.”

    Both Doblin and Mithoefer said they were rebuffed by VA officials when they requested help in recruiting patients for the study. A VA spokeswoman told Military.com the department has no record of requests to treat PTSD patients with MDMA.

    But the former Ranger said he’s confident the VA will explore it as an option once word of the treatment’s success spreads.

    “For me, I moved past those troubles and on to other things, and I couldn’t have done it without [Mithoefer’s] help,” he said. “If it helps Soldiers like me recover, they’re going to have to look at it seriously.”

    by Bryan Mitchell
    March 04, 2009

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  1. chillinwill
    Ecstasy could help patients with post-traumatic stress disorder

    Los Angeles, London, New Delhi, Singapore and Washington DC (March 9th, 2009) – Ecstasy may help suffers of post-traumatic stress learn to deal with their memories more effectively by encouraging a feeling of safety, according to an article in the Journal of Psychopharmacology published today by SAGE. Studies have shown that a type of psychological treatment called exposure therapy – where the patient repeatedly recalls the traumatic experience or is repeatedly exposed to situations that are safe but still trigger their traumatic feelings – can be effective in relieving stress responses in patients with post-traumatic stress disorder (PTSD) and other anxious conditions. The therapy works by helping the patient to re-learn the appropriate response to the trigger situation, a process known as extinction learning.

    But this approach can take some time, and 40% of patients continue to experience post-traumatic stress even after their treatment. To improve outcomes, scientists have been investigating the use of drug therapies to enhance the effect of exposure therapy, making the result of exposure to the fear trigger easier, faster, and more effective. MDMA (the pharmaceutical version of Ecstasy) is one such drug.

    "A goal during exposure therapy for PTSD is to recall distressing experiences while at the same time remaining grounded in the present. Emotional avoidance is the most common obstacle in exposure therapy for PTSD, and high within-session emotional engagement predicts better outcome," explain authors Pål-Ørjan Johansen and Teri Krebs, who are based at the Norwegian University of Science and Technology and supported by the Research Council of Norway.

    Psychiatrists that have administered MDMA to anxiety patients have noted that it promotes emotional engagement; strengthens the bond between the patient and doctor, known as the therapeutic alliance; decreases emotional avoidance; and improves tolerance for recall and processing of painful memories.

    According to Johansen and Krebs, "MDMA [ecstasy] has a combination of pharmacological effects that…could provide a balance of activating emotions while feeling safe and in control."

    They suggest three possible biological reasons why ecstasy could help individuals with PSTD. First, ecstasy is known to increase the release of the hormone oxytocin, which is involved in trust, empathy, and social closeness.

    Because people with PTSD often report feeling emotionally disconnected and unable to benefit from the supportive presence of family and friends or therapists – a situation that is likely to contribute to the development and maintenance of the disorder – use of ecstasy might also help ameliorate these symptoms, suggest the authors.

    "By increasing oxytocin levels, MDMA may strengthen engagement in the therapeutic alliance and facilitate beneficial exposure to interpersonal closeness and mutual trust," they write.

    The second biological explanation for ecstasy's useful effect is that it acts in two brain regions to inhibit the automatic fear response (mediated by the amygadala) and increase emotional control (mediated by the ventromedial prefrontal cortex) and therefore permits bearable revisiting of traumatic memories.

    Thirdly, ecstasy increases the release of two other hormones, noradrenaline and cortisol, which are known to be essential to trigger emotional learning, including the process that leads to fear extinction, on which therapy for PTSD relies. But, caution the authors, while these compounds enhance extinction learning they may also temporarily increase anxiety in people with PTSD because the hormones are naturally released as part of the body's response to stress.

    Ecstasy combined with psychotherapy is a treatment already being tested in clinical trials to help patients with PTSD. All of these trials have a similar design in which ecstasy or placebo is administered to patients a few times during their therapy sessions as part of a short term course of psychological treatment. According to the Johansen and Krebs, recent preliminary results from two of these randomized controlled trials shows that the therapy might have promise.

    "Reduction of avoidance behavior linked to emotions is a common treatment target for all anxiety disorders. MDMA [ecstasy] has a combination of pharmacological effects that, in a therapeutic setting, could provide a balance of activating emotions while feeling safe and in control, as has been described in case reports of MDMA augmented psychotherapy….Future clinical trials could combine MDMA with evidence-based treatment programs for disorders of emotional regulation, such as prolonged exposure therapy for PTSD," conclude the authors.

    Published: Sunday, March 8, 2009
    E! Science News
  2. BloodNutz
    "Ecstasy" may help PTSD victims get better

    "Ecstasy" may help PTSD victims get better

    Thu Mar 19, 2009 8:02pm GMT

    NEW YORK (Reuters Health) - The drug MDMA -- better known as the illegal recreational drug "Ecstasy" -- may help people with posttraumatic stress disorder (PTSD) recover, a Norwegian research team suggests.
    They say the effect of MDMA should allow PTSD patients bond more easily with their therapists, take control of their emotions, and re-learn how to respond to past trauma.

    People with PTSD "are usually running away from what they experienced as very scary, and then they never have this inhibition learning, this fear-learning," Pal-Orjan Johansen of the Norwegian University of Science and Technology in Trondheim commented to Reuters Health. "When the clients are getting MDMA we believe it is easier for them. It becomes more bearable, it becomes easier to regulate, to be in the situation and not run away."

    A couple of small studies in which people with PTSD were given MDMA in addition to standard therapy have had promising results, Johansen and his colleague Teri Krebs, a graduate student in neuroscience at the university, note in their report in the Journal of Psychopharmacology. Meanwhile, three controlled clinical trials of MDMA plus therapy are now underway.
    A minority of people will develop PTSD after surviving traumatic events, such as being raped or serving in combat. They will continually re-experience the traumatic event in an intrusive way, while trying to avoid things that will trigger these memories or remind them of the traumatic experience.

    Currently, the standard treatment for PTSD is extinction-based exposure therapy, in which a therapist guides the person to revisit the traumatic memories repeatedly, until he or she is able to experience them without fear. However, more than 40% of people still have PTSD after undergoing this treatment.

    In their article, the researchers describe three mechanisms for how MDMA might benefit people who aren't cured by therapy alone, and even speed up treatment and make it more effective.

    First, they say, MDMA drug triggers the release of oxytocin, the so-called "cuddle chemical," which reduces fear while boosting trust. This could make it easier for PTSD victims to build a strong relationship with their therapist -- which is key to treatment success.

    Second, the drug could help re-balance the dysfunctional relationship between two brain regions seen in people with PTSD. These individuals show excessive activation of the amygdala and less activity in the ventro-medial prefrontal cortex (vmPFC).

    "The amygdala is the most connected region of your brain, it's doing a lot of stuff, it's really important for emotional regulation and triggering emotional responses to fear," Krebs explained in an interview. In a healthy person's brain, the amygdala and vmPFC are in "constant communication," she added, but in PTSD the overactive amygdala may overpower the vmPFC, making it much more difficult for a person to control their emotional responses to traumatic memories, while making it harder for them to confront these memories.

    The opposite occurs when a person takes MDMA, according to Krebs; his or her amygdala activity is dampened down, while the vmPFC becomes more active. This could help a person feel more in control and better able to revisit traumatic memories, the researchers say.

    Finally, Krebs and Johansen say, MDMA boosts the release of norepinephrine and cortisol, brain chemicals that are essential for emotional learning. Sedative drugs like Valium are sometimes given to people with PTSD, the researchers note, and these may actually blunt the effectiveness of therapy by completely wiping out the stress response to fearful memories, which is needed for re-learning to occur.

    The current report is meant to provide a "framework" for researchers interested in investigating how MDMA might help people with PTSD and other anxiety-related conditions, said Krebs, who with Johansen has received a grant from the Research Council of Norway to investigate the topic. "What we'd really like to see is more research in this area."
    SOURCE: Journal of Psychopharmacology, online March 9, 2009.

    Source Reuters and MSNBC: Google the title and it will pop up (cant post links yet)
  3. Jatelka
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