In study, ecstasy shows promise for treating PTSD
By Kyrie O'Connor | Houston Chronicle | Published: May 6, 2014
A small but important study that has shown remarkable results using a combination of the drug MDMA - known on the street as ecstasy or "Molly" - and conventional therapy to treat post-traumatic stress disorder could be of significant value to thousands of veterans in Texas.
The South Carolina study, performed by Dr. Michael Mithoefer and his wife, Ann, under the auspices of the Multidisciplinary Association for Psychedelic Studies, or MAPS, involves the short-term use, under close psychiatric care, of the drug 3,4-methylenedioxy-N-methylamphetamine, known medically as MDMA.
If approved for psychiatric use, the treatment could offer relief for the thousands of PTSD sufferers in Houston and San Antonio, which have among the largest concentrations of veterans of the Iraq and Afghanistan wars in the country. Of the 130,000 veterans registered in the Houston area, 9,695 have been treated for PTSD, according to the Department of Veterans Affairs.
The study began in 2001 and is currently in its second phase. If a third phase is approved, the therapy almost certainly would be available in Texas in a few years.
"For quite some time we've known the potential of MDMA to help with psychological problems," said Jane C. Maxwell, a senior research scientist in the school of social work at the University of Texas at Austin who studies MDMA, "We've begun to understand that some banned drugs may have special potential. I welcome the fact that we are able to go back and look at these drugs. This is a small study, but it has significant potential."
Aid for abuse victims
Most of the study's subjects were victims of child sexual abuse and rape who hadn't found relief through other therapies. They were given eight to 10 sessions of psychiatric counseling, and in two of the sessions were given a dose of MDMA. They were then allowed, of their own volition, to bring up the memories that had tormented them.
In 83 percent of the 21 cases, according to Mithoefer, the subjects were found to be symptom-free for up to four years later.
"It's tricky talking about a cure, but it is a sustained remission," said Mithoefer.
Three subjects did suffer a relapse. In those cases, they were brought in for a "booster session" of MDMA and counseling, and they returned to a symptom-free state, said Mithoefer.
Mithoefer is now working with a second group of 24 patients who are veterans, firefighters and police officers with PTSD. Similar studies are underway in Israel, Canada, Switzerland and Colorado.
Alex Vitek is a walking tale about why treatment of PTSD is so crucial. When he returned to Houston from a tour of duty as an Air Force medic in Afghanistan in 2007, he brought with him a severe case of PTSD.
"To be honest, it turned my life upside down," Vitek said. He lost his wife and child and his career in the military. He fell into a deep hole of drugs and alcohol. Vitek said he tried suicide multiple times.
"Left untreated, I would have landed six feet deep or in jail," Vitek said
Fortunately, he found Camp Hope, a local Christian-based residential program that uses more conventional treatment methods, such as 12-step programs, counseling and peer-mentoring. Vitek was able to stick with the program and later signed on as an intern at Camp Hope. Now he is on staff as a housing manager. He's a success story.
Mithoefer does not discount other methods of treating post-traumatic stress.
"They are helpful to some and not helpful to others," he said, which makes having a variety of methods important.
One of the hallmarks of MDMA is its ability to evoke openness and closeness in those who take it. Although Mithoefer cautions that no one truly knows how psychoactive drugs work, some facts are known about MDMA.
Scientists know it causes the release of serotonin and other feel-good neurotransmitters and hormones. Brain imaging shows that it decreases the activity of the amygdala, where fear arises, and increases activity in the prefrontal cortex, the site of higher functions.
With MDMA, the subjects are "not overwhelmed with fear," said Mithoefer. "There is more higher-level processing. Those with PTSD have the opposite. It's logical that a drug that causes the reverse of that effect would be helpful."
He cautions that his studies are done in a rigorous clinical setting and in collaboration with the Food and Drug Administration.
"It doesn't mean it doesn't have any risk," he said.
The history of MDMA is literally a long, strange trip. Merck, the pharmaceutical company, filed for a patent in 1912 as a drug to control bleeding.
In 1965, a research scientist name Alexander Shulgin synthesized MDMA and in 1967 tried it himself. By 1977, psychologists had begun to use it - at this point, it's still legal - in their practices for couples counseling, anxiety, post-traumatic stress and pain, said Brad Burge, spokesman for Santa Cruz, Calif.-based MAPS. No research on the drug was done, however.
At the same time, MDMA had a burgeoning career as a party drug. It had traveled down to Texas from the New York club scene, and an entrepreneur in Texas was shipping up to a half-million pills a month to Dallas.
It was sold openly at clubs such as Dallas' famous Starck Club, where everyone from young oil and gas executives to the singer Grace Jones would pass long, lurid nights of dancing and transgression. (A documentary on the Starck Club made its debut in April.)
In 1985, however, the Reagan-era U.S. Drug Enforcement Adminstration placed MDMA, by then known as ecstasy, on its list of Schedule 1 drugs, the level with the highest penalties. Heroin, for example, is a Schedule 1 drug.
New path of study
Now, research in cooperation with the FDA is just starting to open up.
"We're just starting to explore research comparing it to cognitive behavioral therapy, prolonged exposure or eye-movement tracking," said Burge, citing the most common methods of treating PTSD.
Both Burge and Mithoefer caution that this is not a therapy to try at home. Ingesting street Molly in an uncontrolled environment in hopes of achieving Mithoefer's results is a fool's errand. Some street drugs that purport to be ecstasy or Molly don't contain any MDMA, Burge said.
If the results are borne out by further research, Mithoefer believes the FDA will eventually approve MDMA for clinical use.