Methylenedioxymethamphetamine (MDMA)-Assisted Therapy in Hawaii: A Brief Review

The Food and Drug Administration granted breakthrough therapy status to MDMA-assisted therapy in 2017 based on early evidence for treating PTSD. Across six phase-II trials, 54% of participants receiving a full dose no longer met PTSD diagnosis after two sessions, compared to 23% in the control group. In the first phase-III trial, 67% no longer met criteria after three sessions. Effects persisted: 67% remained undiagnosable after one year and 74% after nearly four years. The therapy was being fast-tracked for potential FDA approval by 2023. Hawaii's 2021 Senate Bill 738, which unsuccessfully sought to reschedule psilocybin for major depressive disorder, highlighted that MDMA, also a Schedule I substance, could benefit Hawaii residents.

Study at a glance

Abstract

The Food and Drug Administration (FDA) granted breakthrough therapy status to 3,4-methyl​enedioxy​methamphetamine-assisted therapy (MDMA-AT) in 2017 due to preliminary evidence supporting its efficacy and safety in treating post-traumatic stress disorder (PTSD). A series of six phase-II clinical trials studying MDMA-AT for treatment-resistant PTSD found that 54% of MDMA-AT full-dose participants no longer met the diagnosis of PTSD after two MDMA sessions, compared to 23% in the control group. In the first phase-III clinical trial, 67% no longer met the criteria for PTSD after three sessions. The effects are durable, with 67% no longer diagnosable after one year and 74% at nearly four years. The MDMA-AT is being fast-tracked for potential FDA approval by 2023. In 2021, Hawaii's Senate Bill 738 unsuccessfully proposed that psilocybin be removed from the Schedule I controlled substances list due to its clinical efficacy for major depressive disorder. Methyl​enedioxy​methamphetamine is also a Schedule I controlled substance and has proven to be a treatment option that could potentially benefit the people of Hawaii.