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R. Doblin

5 papers in the library · 226 citations · publishing 2019-2022

Papers

THE EFFECTS OF MDMA-ASSISTED THERAPY ON ALCOHOL AND SUBSTANCE USE IN A PHASE 3 TRIAL FOR TREATMENT OF SEVERE PTSD

Drug and Alcohol Dependence February 1, 2022 Christopher R. Nicholas, Julie B. Wang, A. Coker et al. 67 citations

MDMA-assisted therapy for severe PTSD may also reduce hazardous alcohol use without increasing illicit drug use. In a randomized trial, 90 adults with severe PTSD received either MDMA-assisted therapy or placebo plus therapy. Those in the MDMA group showed a greater reduction in alcohol use scores (average decrease of 1.02 points) compared to a slight increase in the placebo group (average increase of 0.40 points). Changes in drug use scores did not differ between groups. The findings suggest MDMA-assisted therapy could serve as an integrated treatment for co-occurring PTSD and alcohol or substance use disorders.

3,4-methylenedioxymethamphetamine (MDMA) impairs the extinction and reconsolidation of fear memory in rats.

Physiology and Behavior February 1, 2019 H. Hake, Jazmyne Davis, River R. Wood et al. 65 citations

MDMA paired with psychotherapy reduces PTSD symptoms more effectively than psychotherapy or medication alone, but how MDMA enhances therapy is unclear. In adult male rats, MDMA given before fear extinction training impaired later recall of cued fear extinction without affecting fear relapse. MDMA given during the reconsolidation phase—but not outside it—produced a delayed and lasting reduction in conditioned fear. These results suggest MDMA may improve psychotherapy by disrupting fear memories during reconsolidation rather than by enhancing extinction.

The cost-effectiveness of MDMA-assisted psychotherapy for the treatment of chronic, treatment-resistant PTSD

PLoS ONE October 14, 2020 E. Marseille, J. Kahn, B. Yazar-Klosinski et al. 55 citations

For people with severe, chronic PTSD that does not respond to standard treatments, MDMA-assisted psychotherapy (MAP) appears to be cost-saving for health care payers while delivering substantial clinical benefit. A decision-analytic model based on pooled results from six phase 2 trials with 105 subjects and a four-year follow-up of 19 subjects estimated that, over 30 years, MAP for 1,000 individuals generates net discounted savings of $103.2 million and 5,553 additional quality-adjusted life-years (QALYs) compared to continued standard care. MAP breaks even on cost at 3.1 years. Even under the conservative assumption that benefits last only one year, MAP costs $26,427 per QALY gained.

MDMA-assisted therapy for posttraumatic stress disorder: A pooled analysis of ethnoracial differences in efficacy and safety from two Phase 2 open-label lead-in trials and a Phase 3 randomized, blinded placebo-controlled trial

Journal of Psychopharmacology June 21, 2022 T. Ching, Monnica T. Williams, Julie B. Wang et al. 29 citations

In a pooled analysis of two Phase 2 open-label trials and one Phase 3 randomized placebo-controlled trial of MDMA-assisted therapy for PTSD, no significant difference in symptom reduction was found between BIPOC and non-Hispanic White participants who received MDMA. Among those given placebo-assisted therapy, BIPOC participants showed a trend toward greater improvement than non-Hispanic Whites. Non-Hispanic Whites had significantly larger reductions in PTSD symptoms with MDMA than with placebo, but no such treatment difference emerged among BIPOC participants. Adverse events were mostly mild or moderate across all groups. The findings suggest MDMA-assisted therapy is effective and safe across ethnoracial groups, though subgroup sizes were imbalanced.

MDMA-Assisted Therapy for Posttraumatic Stress Disorder: A Mixed-Methods Case Study of a Participant of Color From an Open-Label Trial

Journal of humanistic psychology February 10, 2022 Terence H. W. Ching, Monnica T. Williams, S. Reed et al. 10 citations

A mixed-methods case study examined whether a person of color with treatment-resistant PTSD would benefit from MDMA-assisted therapy (MDMA-AT) as much as participants in earlier, less diverse trials. The participant showed quantitative improvement in PTSD symptoms. An interpretative phenomenological analysis of therapy session transcripts revealed recurrent themes related to psychological mechanisms of symptom change, reduced PTSD symptoms, and additional positive and negative effects beyond symptom reduction. The authors discuss these themes and offer recommendations for addressing culturally relevant material during MDMA-AT.