A psychedelic drug holds so much potential to improve treatment of post-traumatic stress disorder that some Philadelphia-area patients may get it before the U.S. Food and Drug Administration (FDA) gives formal approval.
A new center for MDMA-assisted psychotherapy (MAPS) – the first in the Philadelphia region – plans to open later this summer in Wyndmoor, Montgomery County, and begin offering MAPS early next year pending FDA approval. A second center, run by another provider and based in West Philadelphia, is expected to follow next spring.
MDMA is scientifically known as methyl enedioxy methamphetamine, a synthetic drug that decreases fear and defensiveness while boosting trust and empathy – capabilities that clinicians say enhance the effectiveness of psychotherapy. But it remains classified as a Schedule I drug by the U.S. Drug Enforcement Administration, having gained a reputation in the 1980s as a party drug commonly sold as ecstasy or molly.
Clinicians stress that the MDMA being used medically differs from the street version, which is typically cut with dangerous contaminants. And it only is being used in controlled therapeutic settings; patients cannot take it home.
While the drug does not treat PTSD on its own, it has shown incredible promise in clinical studies when coupled with psychotherapy. MDMA-assisted therapy integrates controlled drug treatments into a psychotherapy course that extends several months. Delivered intermittently, the drug helps patients to work through harrowing experiences otherwise too painful to discuss, even with a professional therapist.
Previous clinical trials administered two or three MDMA treatments to 103 participants during a 12-week psychotherapy course. Just two months afterward, 54 percent no longer had enough symptoms to meet the standards of a PTSD diagnosis. At the 12-month mark, that figure had jumped to 68 percent. And virtually every patient saw his or her symptoms reduced.
PTSD is considered life-threatening due to its strong association with depression and suicide, Burge said. Also, they often have a hyperactive amygdala, a portion of the brain that helps regulates fear and anger, causing them to feel stressed or frightened even when danger is not present. As a result, therapy is difficult because patients are prone to so-called “fight or flight” responses. But the MDMA regulates the amygdala, opening up the psyche in a way that enables patients to examine difficult material without being triggered by it.