How could MDMA (ecstasy) help anxiety disorders? A neurobiological rationale
Journal of Psychopharmacology March 9, 2009 P.-ø. Johansen, Ts Krebs 98 citations
Exposure therapy is effective for anxiety disorders but is underused, with patients often prescribed SSRIs or benzodiazepines that may hinder extinction learning. Given trials testing MDMA with psychotherapy for treatment-resistant anxiety, three mechanisms are proposed: MDMA increases oxytocin, strengthening the therapeutic alliance; it increases ventromedial prefrontal activity and decreases amygdala activity, improving emotional regulation and reducing avoidance; and it increases norepinephrine and cortisol, facilitating emotional engagement and extinction of learned fear. These effects may allow patients to feel safe while processing emotions, as seen in case reports. Further studies are needed.