bioRxiv (Cold Spring Harbor Laboratory) • Matthew J. Baggott, Kathleen J. Garrison • 1 citation
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MDMA (ecstasy) use can cause dangerously low blood sodium levels (hyponatremia), especially when people drink too much water. In two double-blind, placebo-controlled studies, healthy volunteers who took MDMA did not show increased levels of the hormone that normally regulates water balance (ADH or copeptin), but their blood sodium dropped more than with placebo when they drank standardized amounts of water. Women tended to have lower baseline sodium, but this did not significantly interact with MDMA. The findings indicate that consuming hypotonic fluids during MDMA use poses a significant risk of hyponatremia, which should be anticipated and managed in clinical and recreational settings.
Minsu Yoo, Sofia Sakopoulos
The commercialization of psychedelics like psilocybin, LSD, and MDMA for mental health treatment blurs the line between impartial science and profit-driven industry. Based on in-depth interviews with stakeholders, the study reveals how venture capitalists not only fund research but also provide regulatory and industry knowledge, creating ethical dilemmas for scientists. Researchers' reluctance to disclose personal psychedelic experiences during interviews signals a shift from an illegality paradigm to one of intellectual property. The findings suggest that ethical dynamics in scientific practice must be reconsidered, particularly how public and private funders shape researchers' priorities.
Research Square • Sean Viña
People who use psychedelics are less likely to seek formal mental health care, including medication and outpatient treatment, even when experiencing high psychological distress. Analyzing data from over 458,000 participants in a national US survey between 2010 and 2018, the study found that as distress levels increase, psychedelic users become even less inclined to use formal care compared to non-users. This suggests a heightened risk of self-medication as psychedelics become more culturally and legally accepted.
Preprints.org • Kainat Riaz, Sejal Suneel, Mohammad Hamza Bin Abdul Malik et al. • 1 citation
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Half of patients with post-traumatic stress disorder (PTSD) do not respond to standard pharmacotherapy or psychotherapy. A review of six phase II randomized controlled trials indicates that MDMA-assisted psychotherapy can reduce PTSD symptoms, even in treatment-resistant cases, by increasing neurohormones such as dopamine, serotonin, norepinephrine, and oxytocin and by modulating brain regions involved in fear and anxiety. The FDA has granted MDMA-assisted psychotherapy a "Breakthrough Therapy" designation. Further research is needed to determine whether the benefits outweigh the risks and whether this approach can be integrated into existing treatment options.
medRxiv • W. M. Green, S.b. Raut, F.l.j. James et al. • 4 citations
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MDMA-assisted psychotherapy improves dissociation, depression, and functional impairment in people with post-traumatic stress disorder (PTSD), but does not improve sleep quality. A systematic review and meta-analysis of randomized controlled trials found that the therapy reduces core PTSD symptoms and enhances quality of life. The evidence is limited by small sample sizes in available trials, but supports further development of MDMA-assisted psychotherapy for PTSD.
Kenneth Shinozuka, Burton J. Tabaac, Alejandro Arenas et al.
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MDMA, known as a party drug in the 1980s, is emerging as a powerful treatment for PTSD. Phase III FDA trials show MDMA-assisted psychotherapy has an effect size of 0.7-0.91, two to three times larger than existing antidepressants. Within 18 weeks, 67 to 71% of patients no longer meet PTSD diagnostic criteria. The literature is biased: animal studies used doses far above human levels, and human samples often involve recreational users of multiple substances. Only six clinical trials, all by MAPS, have been conducted, but preliminary evidence suggests MDMA is much more effective than current antidepressants for PTSD.
Jason B Luoma, Luke Roy Allen, Veronika Gold et al. • 1 citation
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MDMA is being tested as an adjunct to psychotherapy in controlled trials, including two completed Phase 3 trials, and could become a legally available medicine for MDMA-assisted therapy (MDMA-AT) within a few years. The treatment manual for MDMA-AT research considers touch an important part of therapy, but no empirical evaluation has examined how touch functions in MDMA-AT, and research on touch in psychotherapy generally is scarce. Concerns exist that touch combined with MDMA could intensify power imbalances or contribute to boundary crossings and unethical behavior.
Jason B Luoma, M. Kati Lear, Kyong Yi et al.
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A man in his late 30s with generalized social anxiety disorder (SAD) received MDMA-assisted therapy that included imaginal exposure to shame-related memories and in vivo social exposures during drug sessions, plus imagery rescripting and social activation homework. His symptoms and functional impairment, measured by the Leibowitz Social Anxiety Scale and Sheehan Disability Scale, showed significant reduction. He reported increased social engagement, less anxiety in social situations, and more self-compassion. The participant found exposures during MDMA sessions particularly impactful, allowing access to intrinsic desires for social connection. The authors suggest MDMA-assisted therapy with exposure techniques may be a promising treatment for SAD, warranting further research.
Philip Gerrans, Hugh Mgovern, Jakob Hohwy et al. • 1 citation
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Complex post-traumatic stress disorder (C-PTSD) involves additional symptoms beyond those of PTSD, including emotional instability, negative self-concept, and interpersonal difficulties, often from prolonged trauma like childhood maltreatment or domestic violence. A novel model based on active inference and self-modelling explains these differences and identifies the insula's role in affective regulation. The model suggests that MDMA-assisted therapy may help recalibrate emotional regulation and strengthen self-model, offering a potential treatment avenue. Theoretical and clinical implications are discussed, with emphasis on further empirical research.
Balazs Szigeti, Ellen Bradley, Joshua Woolley
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Unmasking bias—where participants or researchers can guess who received a treatment due to its noticeable effects—may account for the reported benefits of MDMA-assisted therapy for PTSD. Analyzing data from trials of ketamine and escitalopram, the authors found that the magnitude of unmasking bias is larger than the treatment-versus-control effect size observed for MDMA. This indicates that MDMA-AT's effect sizes are not too large to be explained by unmasking alone, though the findings do not prove that the effects are entirely or partially due to this bias.