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Psychedelic Medicine: Using Ecstasy to Treat PTSD

By Wanderer, Jul 25, 2010 | Updated: Jul 25, 2010 | | |
Rating:
5/5,
  1. Wanderer
    After MDMA-assisted psychotherapy, over 80 percent of sufferers from post traumatic stress disorder no longer met the diagnostic criteria for PTSD, as compared to only 25 percent in the control group. This study, just released, was conducted by Michael Mithoefer, M.D. (and his colleagues) and is published in the peer-reviewed Journal of Psychopharmacology.

    According to the media statement, MDMA, recreationally referred to as Ecstasy, could "offer sufferers a vital window with reduced fear responses where psychotherapy can take effect." According to the paper, participants in the study experienced "no drug-related serious adverse events, adverse neurocognitive effects or clinically significant blood pressure increases."

    On the killing fields of 1914-19, the malady being studied was called "shell shock," in World War Two, "battle fatigue" or "combat exhaustion," and now, in the era of military operations in Iraq and Afghanistan, PTSD. It can be caused, for example, by experiencing random explosions, being wounded or seeing buddies torn open or killed.

    The syndrome is hard to treat and can last for years after a soldier climbs out of a trench or an armored personnel carrier. Of course it helps to be in a psychotherapist's quiet office, away from any battlefield or dangerous city. But PTSD tends to stay with a person. He or she may bring it to bed (as partners discover when a returning vet wakes up screaming), to the highway, to workplaces, perhaps to any argument or frustration or hearing of loud sounds. What to do?

    The problem is fear--pervasive, invasive, recurrent fear. What MDMA does, according to the research, is to provide at least a brief experience of what life feels like without the aftermath of trauma. In this state, learning can occur.

    The political system that conducts wars in Vietnam, Iraq and Afghanistan used to "just say no" to all psychoactive drugs, but now needs something to help veterans of those wars who suffer PTSD. In this situation, MDMA might be officially repurposed. What was for a while mainly a party drug at raves is now moving back toward (if not yet into) the therapy office.

    PTSD is suffered not only by some warriors, but also by rape and other crime victims, by people who have been in accidents, by minors who suffer abuse.

    Before being "scheduled" (criminalized) 25 years ago, MDMA was used by a circle of therapists for a variety of purposes, including internal exploration. For example, George Greer, M.D. and Requa Tolbert wrote a paper in 1986 on how they'd given MDMA in a clinical setting. The Mithoefer research just reported is methodologically superior to theirs, and focused tightly on PTSD, but it is hard to find any substantial contradiction of what they wrote in 1985 or to conclude that, because of political hysteria, we have not just wasted a quarter century.

    Research is quietly being conducted not only on MDMA (which has been labeled an "empathogen" or "entactogen") but also on classic psychedelics such as psilocybin. Much of this work is sponsored by a group of scientists banded together in the Heffter Institute (a name borrowed from a German pharmacologist born in the mid 19th century). Many of the published papers are technical, with such titles as "psylocybin links binocular rivalry switch rate to attention and subjective arousal levels in humans."

    But Heffter also sponsors clinical and basic research friendlier to laypeople. For example, they are supporting studies of the use of psilocybin and other psychoactive molecules, conducted at Johns Hopkins, NYU, Perdue, UCLA, and the University of Zurich. Some of this research deals with cancer patients and people with obsessive-compulsive disorder; some, with the way various molecules work in the nervous system. Heffter has gathered most of the big names in the field, plus some generous supporters.

    Along with the Council on Spiritual Practices (in San Francisco), the Multidiscplinary Association for Psychedelic Studies (with an office in Santa Cruz), and the Beckley Foundation (located in England), the Heffter Institute (with an office in Santa Fe) co-sponsored a conference in April in the Bay Area and supports much of the "psychedelic science" being conducted abroad and, as the Federal government gradually allows it, in the U.S.

    If pharmaceutical firms could profit from these substances and if the latter hadn't been associated with hedonism in a time characterized by protest against a war and against racism, perhaps this process of official rediscovery would have moved less tardily. Meanwhile, sufferers from PTSD and other maladies who are helped can give thanks to the scientists and other pioneers who have kept working to explore the benefits and safe uses of mind-manifesting molecules.


    Around the Web:
    Ecstasy May Help With Post Traumatic Stress Disorder
    Smoking Some Weed to Deal with PTSD? - Ecstasy May Be the Better ...
    MDMA ( Ecstasy ) in the treatment of posttraumatic stress disorder ...
    Ecstasy May Improve PTSD Symptoms


    Craig K. Comstock
    Book creation coach and former director of the Ark Foundation
    Posted: July 23, 2010 03:17 PM
    HuffingtonPost.com


    http://www.huffingtonpost.com/craig-k-comstock/psychedelic-medicine-usin_b_651280.html

Comments

  1. Wanderer
    Ecstasy May Help With Post Traumatic Stress Disorder

    Ecstasy may help suffers of post-traumatic stress learn to deal with their memories more effectively by encouraging a feeling of safety, says new research.

    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.


    RELATED ARTICLES ON SCIENTIFIC BLOGGING:(These follow this article)

    Rwandan Genocide Illustrates How Genetics Influence PTSD
    Risk For PTSD Influenced By Genetics And Environment, Study Finds
    Odd Good News For Soldiers: Some Brain Injuries Reduce Post Traumatic Stress
    Earthquake Social Aftershocks - Post Traumatic Stress Disorder Runs In Families
    Post-Traumatic Stress Is A Genetic Issue Too: Study


    By News Staff
    March 8th 2009 11:41 PM
    Science Blogging - Science 2.0

    Article: 'How could MDMA (ecstasy) help anxiety disorders? A neurobiological rationale', PØ Johansen and TS Krebs, Journal of Psychopharmacology.
    Article Original: http://www.science20.com/news_releases/ecstasy_may_help_post_traumatic_stress_disorder
  2. Wanderer
    Smoking Some Weed to Deal with PTSD? – Ecstasy May Be the Better Choice

    I used to smoke weed – a lot of weed. Back in my teen years. From the time I woke up until the minute I went to sleep, I was high. I even went to jail briefly for trying to grow my own personal supply (the judge didn’t quite see the “can do” spirit in my endeavor).
    [​IMG]
    One thing I noticed from spending several years of my life in a literal cloud of smoke was that all development stopped. My emotional life was stunted, my physical skills were stunted (possibly costing me a career as a soccer player), and my relationships were stunted.

    That was 25 years ago – haven’t smoked since then. [Update: I should have mentioned this before - I was suffering PTSD from the sudden death of my father when I was 13 - and using weed to self-medicate the grief and the other symptoms of PTSD.]

    Since I last used, the potency of marijuana has increased substantially (from 10-15% THC in what we grew back in the 80s to as much as 25-30% THC now – The highest concentration of THC found in a single sample was 37.2%). The imbalance brought about by increasing THC without increasing the other cannibnoids, some of which are actually good for the brain has resulted in a substantial increase of psychosis in users. At particular risk are teens who smoke, becoming more likely to suffer psychosis later in life (typical age of psychotic onset is 18-35).

    John McGrath, MD, PhD, FRANZCP; Joy Welham, MAPs; James Scott, MBBS, FRANZCP; Daniel Varghese, MBBS, FRANZCP; Louisa Degenhardt, PhD; et al. (2010). Association Between Cannabis Use and Psychosis-Related Outcomes Using Sibling Pair Analysis in a Cohort of Young Adults. Arch Gen Psychiatry. 2010;67(5):440-447.

    We know that there are many psychological effects of marijuana use (and possible mental health issues, as already noted), such as the following:

    distorted sense of time
    paranoia
    magical or “random” thinking
    short-term memory loss
    anxiety and depression
    As a further example, people with social anxiety disorder, such as myself, are much more likely than an average person to smoke weed. We do not expect that getting high makes the SAD better, however, we actually expect to make it worse, which it does. People with anxiety issues should not smoke weed – and yet they do so much more than other people, knowing that it actually makes cognitive and behavioral issues worse.

    In addition to decreased testosterone in men and short-term memory damage, there are other issues with chronic use according to the Gale Encyclopedia of Psychology (2nd ed., Gale Group, 2001):

    THC has been found to destroy cells in the hippocampus, a part of the brain that is important in the formation of new memories. Psychologically, chronic use of marijuana has been associated with a loss of ambition known as amotivational syndrome.

    Considering all we know, it’s amazing that anyone would consider using weed for Post-Traumatic Stress Disorder (PTSD), which is an anxiety disorder. But that is exactly the topic of a recent NPR story on Morning Edition. Here is some of the story:

    Can Marijuana Ease PTSD? A Debate Brews

    by Jeff Brady

    [IMGL="white"]http://www.drugs-forum.com/forum/attachment.php?attachmentid=15723&stc=1&d=1280067045[/IMGL]The Department of Veterans Affairs finds itself in a difficult position because some vets want to use marijuana to treat symptoms of post-traumatic stress disorder. Pot possession remains illegal under federal law. The VA says that as a federal agency its doctors can’t recommend using it.

    The problem is especially acute in New Mexico, where one-fourth of the state’s more than 1,600 medical marijuana patients are PTSD sufferers.

    ‘Medical Cannabis Saved Our Marriage’

    Paul Culkin of Rio Rancho, N.M., traces his PTSD back to 2004 when he was in Kosovo and part of an Army bomb squad. A car crashed into a business. The manager was inside trying to put out a fire. Culkin went in once to try to get him to leave, but he wouldn’t go.

    “The second time when I went in to get him out of there — that’s when the car bomb exploded and the glass hit me,” Culkin says.

    He recovered from the physical wounds, but years later the trauma of that moment can come back without warning.

    “Sometimes you’ll see a car that’s just not in the right place and it’ll send me back to that thinking that it could, possibly, be a car bomb,” Culkin says.

    Culkin started avoiding social situations and was quick to anger. He says the treatment he’s received from the VA — mostly counseling and antidepressant medication — has helped. But, he says, marijuana also works well to relieve his anxiety.

    To be legal in New Mexico, he had to go outside the VA system and pay for another doctor and a psychiatrist to recommend him for the state’s medical marijuana program. Then he spent more than $1,500 to set up a small growing operation in his garage.



    Enlarge Jeff Brady/NPR Victoria Culkin says that her husband Paul’s marijuana use saved their marriage.

    Culkin says he doesn’t usually smoke the marijuana, instead choosing to dissolve an extract in hot chocolate or tea so he can control the dose better.

    His wife, Victoria, says the marijuana has made a big difference.

    “He’s a different person. He’s a better person. He’s more open. He’s more communicative,” she says. “At one point, we almost got a divorce, and I can honestly say that I think medical cannabis saved our marriage and our family.”

    Sounds great, doesn’t it? Weed saved his marriage. But then there is the medical point of view:

    “There is no solid evidence that cannabinoids — that marijuana — is, in itself, an effective treatment for post-traumatic stress disorder,” says Dr. David Spiegel, director of the Stanford Center on Stress and Health. “Before anyone can claim that, there needs to be some more solid research on that topic.”

    Spiegel says recovery from trauma begins with the victims regaining control, over both their bodies and their mental reactions to the traumatic event. Smoking marijuana could make that more difficult, he says.

    “The last thing you want is to be losing control at a time when you’re remembering an event in which you lost control,” Spiegel says.

    According the National Institute of Mental Health, the following are the three main groupings of symptoms for those with PTSD:

    1. Re-experiencing symptoms:

    Flashbacks—reliving the trauma over and over, including physical symptoms like a racing heart or sweating
    Bad dreams
    Frightening thoughts.
    Re-experiencing symptoms may cause problems in a person’s everyday routine. They can start from the person’s own thoughts and feelings. Words, objects, or situations that are reminders of the event can also trigger re-experiencing.

    2. Avoidance symptoms:

    Staying away from places, events, or objects that are reminders of the experience
    Feeling emotionally numb
    Feeling strong guilt, depression, or worry
    Losing interest in activities that were enjoyable in the past
    Having trouble remembering the dangerous event.
    Things that remind a person of the traumatic event can trigger avoidance symptoms. These symptoms may cause a person to change his or her personal routine. For example, after a bad car accident, a person who usually drives may avoid driving or riding in a car.

    3. Hyperarousal symptoms:

    Being easily startled
    Feeling tense or “on edge”
    Having difficulty sleeping, and/or having angry outbursts.
    Hyperarousal symptoms are usually constant, instead of being triggered by things that remind one of the traumatic event. They can make the person feel stressed and angry. These symptoms may make it hard to do daily tasks, such as sleeping, eating, or concentrating.

    A major element of the symptoms is the hyperarousal, which the weed might help (since it makes users sleepy), but there is also the emotional blunting (made worse by weed), the feeling of being on edge/anxious (made worse by weed, over time), trouble remembering the trauma, which might seem great, but slows the healing (made worse by weed), and bad dreams or flashbacks of the event (made worse by weed, just as negative LSD flashbacks are more likely when high).

    Antidepressants and talk therapy (and more recently EMDR) are the common treatments. The effectiveness is not the best – and it takes years when it is effective, which is why the military is looking at other approaches.

    One new approach getting a lot of attention in the last few years (though not from the military) is treating PTSD with MDMA, more commonly known as ecstasy, E, X, and so on.

    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.

    There are literally dozens of papers on this – none of which reporting any negative side effects of note.

    However, one risk factor is that MDMA can deplete serotonin levels in the brain (neurotoxicity), leading to depression, but the administration of alpha lipoic acid and other antioxidants can completely eliminate this issue (by the way, apparently THC is also neuroprotective in MDMA use, but the two would mostly cancel each other out in treating PTSD).

    Supervised MDMA therapy is where we should be looking for treatment – not to smoking weed, which simply makes the issue worse in the long term and only serves to mask the symptoms. MDMA, on the other hand, treats the underlying issues and need not be used long term to be useful. Seems like the better choice all around.


    By William Harryman
    on May 21, 2010
    Elephant Journal

    http://www.elephantjournal.com/2010...l-with-ptsd-ecstasy-may-be-the-better-choice/
  3. Wanderer
    Ecstasy May Improve PTSD Symptoms

    [IMGL="white"]http://www.drugs-forum.com/forum/attachment.php?attachmentid=15724&stc=1&d=1280067410[/IMGL]CA, United States (AHN) - Researchers say a key ingredient in the popular party drug ecstasy could be used as an effective therapy for patients suffering with post traumatic stress disorder.


    The Multidisciplinary Association for Psychedelic Studies, or MAPS, said in a statement that preliminary studies show MDMA combined with psychotherapy can help people overcome PTSD. The findings were part of the organization’s 10-year, $10 million study on the matter.

    MAPS said in on its website that it is the only organization funding the study because there is little profit to be made from MDMA since its patent has expired. Also, since the drug is not meant for daily use, drug companies see little profit potential, according to MAPS.

    The MAPS website suggests calling MDMA ecstasy is misleading because the street version does not always contain pure MDMA.

    Results of the study are published in the Journal of Psychopharmacology.



    Read more: http://www.allheadlinenews.com/articles/7019321247#ixzz0uhgViTS7


    David Goodhue
    AHN News Reporter
    July 19, 2010 6:35 a.m. EST
    All Headline News


    http://www.allheadlinenews.com/articles/7019321247
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