MDMA (Ecstasy) Effects, Dangers & PTSD Research

MDMA and PTSD – Alcohol and Drug Foundation

MDMA (Ecstasy) Effects, Dangers & PTSD Research

MDMA – or 3,4-methylenedioxymethamphetamine – is a chemical psychoactive substance that forms the main ingredient for the recreational drug, ecstasy. Clinical trials currently underway using MDMA as an adjunct therapy for the management and treatment of PTSD are demonstrating positive results.

Originally manufactured in the early 1900s to help control bleeding, MDMA became more commonly used in the 1970s and early 1980s by some psychiatrists to assist in the treatment of Post-Traumatic Stress Disorder (PTSD).1

PTSD is a disorder that develops in some people who experience a shocking, dangerous or traumatic event. At any given point, there are 1.4 million Australians suffering from PTSD.3 Continuing symptoms, include flashbacks, family disruption, increased use of alcohol and other drugs, and suicide.2

The main theory behind using MDMA to treat PTSD lies with a key symptom of the disorder being avoidance of emotions due to anxiety and re-traumatising.4 MDMA, often referred to as “empathogen” or “entactogen”, tends to increase the feelings of empathy and trust, and allows for an “increased awareness of inner experience”.2

How does it work as a therapeutic agent?

A key aspect behind why MDMA is demonstrating effectiveness for the management and treatment of PTSD in a clinical setting, is its apparent ability to assist patients to be more expressive during a controlled psychotherapy session.

MDMA appears to reduce anxiety associated with recalling traumatic experiences allowing for increased insight and memory. Negative memories are perceived as less negative allowing for the therapist and the patient to engage in productive therapeutic sessions without the patient becoming hyper-aroused due to stress.

In combination with psychotherapy, the use of MDMA provides the capacity “to hold the traumatised patient in a state of emotional security, providing a state of empathic self-reflection in which, for the first time in their lives, they can be with their traumatic memories without being overwhelmed by the powerful negative affect that usually accompanies recall of their most frightening thoughts”.5

MDMA’s main effect is through stimulating the release of a brain chemical called serotonin. Serotonin helps us regulate mood, appetite, sleep, temperature and sexual desire. When consumed, MDMA triggers the release of large amounts of serotonin which can significantly improve mood, confidence and feelings of happiness, as well as enhance positive social behaviour.

There appears to be very limited side effects to the treatment when used in a controlled setting. Long term harms are rare and rigorous experimental trials have found no long-term neurocognitive deficits in participants.2

Current research

Early clinical trials demonstrated positive results, with some researchers claiming that one MDMA assisted psychotherapy session can give results equivalent to five months of weekly therapy.6 However, research into the use of the drug as a therapeutic agent was shut down in 1986 when the drug was made illegal around the world due to increased use in recreational settings.

Restrictions on research were lifted in the early 1990s when the United States FDA (Food and Drug Administration) approved experiments in which MDMA could be used as an adjunct to psychotherapy. In 2017 the FDA referred to MDMA assisted treatment for PTSD as a ‘breakthrough therapy’ and formally endorsed the use of the drug in clinical trials.4

MDMA is not ecstasy

Whilst the research into the use of MDMA for PTSD appears promising, it is important to note that clinical MDMA and recreational ecstasy share few comparable features.

Recreational ecstasy may only contain a minimal amount of actual MDMA with the other ingredients unknown and thus potentially dangerous, dosage cannot be regulated and those that choose to take the drug have not undergone any rigorous testing to ensure that they are fit to consume.

Clinical MDMA, on the other hand, when manufactured in a controlled clinical environment, is pure and all ingredients and dosage is known.

Its use is highly regulated and administered only in a controlled session with trained health professionals.

Treatment is only available for patients that meet a positive diagnosis of PTSD and any side effects are managed by trained medical professionals.

Understanding the clear distinction between the two types of drugs and the way they are used is important. Being clear on their differences helps to ensure that media reporting of toxicity or harms caused by ecstasy doesn’t adversely impact on the potential of MDMA being a successful and safe drug to treat people with an often debilitating psychiatric condition.

It is also important to note that MDMA is used as an adjunct to ongoing psychotherapy and only used in a controlled environment, for a select few people, and with highly trained professionals. There is no clinical use of ecstasy as a recreational drug.


Ecstasy as a Remedy for PTSD? You Probably Have Some Questions

MDMA (Ecstasy) Effects, Dangers & PTSD Research
Continue reading the main story

The drug known by the street names Ecstasy or Molly could be a promising treatment for post-traumatic stress disorder, according to a new study.

Research published Tuesday in the British journal The Lancet Psychiatry found that after two sessions of psychotherapy with the party drug, officially known as MDMA, a majority of 26 combat veterans and first responders with chronic PTSD who had not been helped by traditional methods saw dramatic decreases in symptoms.

The improvements were so dramatic that 68 percent of the patients no longer met the clinical criteria for PTSD. Patients taking the drug also experienced “drastic” improvements in sleep and became more conscientious, according to the study.

The results, which mirror those of similar, small-scale studies of the illegal drug in recent years, come as MDMA is about to enter larger, Phase 3 trials this summer.

previous results, the Food and Drug Administration has given MDMA breakthrough therapy status, which could speed approval.

If large-scale trials can replicate safety and efficacy results, the drug could be approved for legal use by 2021.

“I was finally able to process all the dark stuff that happened,” Nicholas Blackston, 32, a study participant who had been a Marine machine-gunner in Iraq, said in an interview. “I was able to forgive myself. It was a clean sweep.”

But the possible legalization of a widely abused party drug raises a lot of questions.

No one goes home with a bottle of Ecstasy.

If approved by the F.D.A., MDMA would only be administered by a licensed therapist. First, a patient goes through three sessions of psychotherapy. In the fourth session, the patient takes a pill.

After taking the drug, the patient lies on a futon amid candles and fresh flowers, listening to music. Two therapists — one female, one male — sit at the patient’s side as guides. That session lasts eight hours.

“We encourage them to set aside all expectation and agenda and be open. Experiences tend to be very individual,” said Dr. Michael Mithoefer, one of the principal researchers.

The drug floods the brain with hormones and neurotransmitters that evoke feelings of trust and well-being, users report. Researchers say this allows patients to re-examine traumatic memories.

In follow-up psychotherapy, patients process emotions and insights brought up during the MDMA session. The current protocol calls for patients to take MDMA two or three times, each a month apart, interspersed with psychotherapy.

“The MDMA alone or the therapy alone don’t appear to be as effective,” Dr. Mithoefer said. “The MDMA seems to act as a catalyst that allows the healing to happen.”

“I was actually able to forgive myself,” said Nigel McCourry, 36 a Marine veteran who was deployed in 2004 to Falluja, Iraq, whose experiences mirrored those of three other patients interviewed.

Mr. McCourry came home from war unable to escape scenes of an explosion that nearly killed him, and haunted by the memory of two young girls he accidentally killed in a fire fight. He struggled to sleep. He drank to forget. Rage eroded most of his relationships.

He tried help at a Veterans Affairs hospital, but couldn’t let his guard down enough to benefit from standard psychotherapy. A handful of medications meant to help left him feeling a zombie, and he gave them up. He was contemplating suicide when he tried MDMA.

“When it kicked in, it was an epiphany,” he said. “I could see all these things from combat I was afraid to look at before, and I had a totally new perspective. I relived the parts of me I had lost. I realized I had viewed myself as a monster, and I was able to start to have some compassion for myself. It was a turning point, and for the next year I continued to get better.”

“There are also still some challenges I have to face from time to time related to the PTSD,” he added. “But now I am able to work through them without getting stuck.”

That’s an open question.

Large-scale trials, which will include up to 300 participants at 14 sites, may not be able to replicate the success of previous trials, which were limited to a few dozen patients. But so far, results are encouraging.

Nearly all patients saw clinically significant reductions in symptoms, and a majority saw such drastic reductions that they no longer met the criteria for a PTSD diagnosis.

In the 12 months after MDMA therapy, PTSD symptoms generally continued to decrease.

Side effects, including anxiety, headache, fatigue, muscle tension and insomnia, were generally minor and limited to the days following the MDMA sessions.

Other researchers, intrigued by the results, are starting their own studies of MDMA therapy, including the Department of Veterans Affairs.

Not really, said Dr. John Krystal, who heads the Neurosciences Division at the Department of Veterans Affairs National Center for PTSD. He described the current lack of effective therapy as “a crisis.”

“The problem is that we don’t have many treatments and what we have doesn’t work that well,” he said.

Only about one in three combat veterans with PTSD are effectively treated, he said.

Doctors often use a combination of off-label drugs to try to manage patients’ nightmares, flashbacks and depression, but the drugs do nothing to treat the underlying condition, and can have negative side effects.

Psychotherapy also has limitations. Though many patients find it helpful, others find it too traumatizing or ineffective and quit therapy. In some studies, dropout rates were as high as 40 percent.

Not big pharma. The research is organized by a small nonprofit called the Multidisciplinary Association for Psychedelic Studies, or M.A.P.S., which was created in 1986 shortly after MDMA was outlawed.

“No one else would touch this, so we had to do it,” said the founder of M.A.P.S., Rick Doblin, who has a doctorate in public policy from Harvard and has made legalizing MDMA his life’s work.

The Phase 3 trials are expected to cost $27 million.

It’s all donations. And they have come from an odd array of sources. David Bronner, the vegan C.E.O. — that’s Cosmic Engagement Officer — of Dr. Bronner’s Magic Soaps and an unapologetic evangelist for psychedelics has given $5 million.

But also in the mix are the archconservative Mercer family, who typically fund right-leaning institutions including Cambridge Analytica and Breitbart News; the late Richard Rockefeller, a champion of public health; and an anonymous donor known only as Pine, who transferred $5 million in Bitcoin.

People already are. The National Survey on Drug Use and Health found that in 2014 more than 17 million Americans reported using MDMA. While many are ly doing it purely for recreation, word of the therapeutic uses has spread, and combat veterans are trying it illegally at home.

But street Ecstasy is dangerous. Doses of the street drug can be an unknown mix of other stimulants and hallucinogens, and an overdose can be fatal. High frequency use of MDMA can also damage the brain.

M.A.P.S. would at first. MDMA was originally patented by pharmaceutical giant Merck in 1912, but it was never marketed and the patent lapsed. The F.D.A. grants temporary “data exclusivity” to groups that show new uses for drugs with expired patents. That would give M.A.P.S. a five-year monopoly in the U.S. After that, other companies could make it.

M.A.P.S. plans to spin off sales to a for-profit benefit corporation, which would then funnel the money back into clinical research on the use of MDMA with other disorders.

Yes and no. MDMA is an illegal drug and has never been approved for any use by the F.D.A. But for about a decade before it was outlawed in 1985, it was used as an aid in psychotherapy, especially on the West Coast.

At the time, academics were beginning to argue that it and other psychedelic drugs could be a useful ally in psychotherapy. The idea failed to gain traction then, but now a number of prestigious researchers are studying the potential therapeutic uses of LSD, psilocybin and MDMA.

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MDMA and PTSD: Dangerous Mix or Potential Help?

MDMA (Ecstasy) Effects, Dangers & PTSD Research

Once known as a club drug, MDMA – commonly referred to as Ecstasy or Molly – is being studied as a potential treatment for post-traumatic stress disorder (PTSD). PTSD is a psychiatric disorder that results from a traumatic experience, experiencing or witnessing an especially life-threatening, horrifying, or dangerous event.

In addition to combat veterans, there are several other groups (for example, rape victims and emergency responders) who are at higher risk for this condition. PTSD can be characterized by flashbacks to the traumatic event, frightening thoughts, angry outbursts, and exaggerated feelings of guilt or blame, among other symptoms.

It is estimated that eight million adult Americans suffer from PTSD. Around 37 percent of all cases of PTSD are considered severe, which means they are typically resistant to traditional therapy and medications, such as cognitive behavioral therapy (CBT), and antidepressants.

In November 2016, as a response to treatment-resistant cases of PTSD, the U.S.

Food and Drug Administration (FDA) approved large-scale Phase 3 clinical trials with MDMA – the last step before a drug can be approved by the FDA for medical use.

This represented a major move by the FDA to test the effectiveness of a substance that had been deemed illicit for over 30 years as a pharmaceutical therapy for a very difficult condition to treat.

The background story

MDMA was first synthesized in 1912 by German chemist Anton Köllisch. However, he never experimented with it.

In 1976, American chemist Alexander Shulgin also synthesized the chemical without prior knowledge of Köllisch’s discovery.

Shulgin tried MDMA – and though he found its effects unremarkable, he began to encourage psychotherapists to utilize it with patients as a conduit to deeper emotional experience. 

This experimentation by therapists and their patients increased the prevalence of recreational use or misuse of the drug. At the time, most people’s understanding of MDMA and its effects was limited. By the early 1980’s, MDMA was widely used as a club drug, associated with dance parties and electronic music.

Yet MDMA has proven to be a dangerous substance for some users, potentially leading to high blood pressure, heart problems, hyperthermia, loss of consciousness, and seizures. The drug was frequently mixed with alcohol or stimulants, increasing its health risks.

In 1985, the drug was officially designated by the FDA as a Schedule 1 substance – “an illegal drug with no recognized medicinal use.”

Today, MDMA is still used among those participating in “clubbing” or rave party scenes. In 2015, approximately one percent of Americans – primarily young adults – reported using MDMA.

The potential to help

There are now four FDA-approved studies underway to explore MDMA’s effectiveness in treating severe PTSD. When administered, MDMA is taken in a quiet, secure room, with therapists present. Patients are guided through the experience, and asked to explore issues surrounding their PTSD.

Chemically, MDMA appears to work with severe PTSD by increasing levels of brain chemicals (neurotransmitters) serotonin, dopamine, and oxytocin which increase feelings of well-being and emotional closeness, while decreasing depression. Indeed, the chemicals in MDMA seem to let patients think of their traumatic experiences from a different, less threatening perspective.

So far, the test results have been encouraging. In one study from 2008, 83 percent of participants with chronic PTSD saw a significant reduction in their symptoms after two therapeutic MDMA sessions.

A 2012 study also demonstrated a decline in symptoms, though it recommended three sessions of MDMA for the greatest effectiveness.

MDMA appears to have none of the negative, long-term side-affects that antidepressant and anxiety medications have, lack of energy, weight-gain, and suicidality.

The future of PTSD treatment?

Experts and health officials suggest caution with this new approach, as more data is needed to better understand the effectiveness and long-term side effects of MDMA for treating PTSD. Although the FDA is working towards making MDMA an accessible medication, this move has drawn concern about normalizing its use and reigniting the popularity of a drug with known risks and abuse potential.

While initial tests of the effectiveness of the drug for treating PTSD are promising, MDMA should not be used recreationally, or for medical purposes without the close supervision of a trained physician and therapist. Still, if properly regulated, MDMA may end up playing an important role in helping those who suffer tremendously from severe PTSD who would otherwise be unresponsive to treatment.

  Max Dorfman, MA

  Max is a Science Writer at Center on Addiction


Can MDMA Be Used to Treat PTSD?

MDMA (Ecstasy) Effects, Dangers & PTSD Research

Peter Dazeley / Photographer's Choice / Getty Images

When most people hear MDMA, they think of illicit and adulterated preparations of the club drug sold as Molly or ecstasy. In reality, however, these street versions often contain adulterants and little or no of the active ingredient 3,4-methylenedioxymethamphetamine (MDMA). 

Although ecstasy has been linked to long-term neurological effects and even death—associations that some experts dispute—MDMA has proven safe and non-addictive in some clinical studies. Moreover, MDMA may be effective when combined with psychotherapy to treat PTSD.

Post-traumatic stress disorder (PTSD) is a disorder that results from exposure to a traumatic experience a life-threatening event, natural disaster, or violence.

 People with PTSD live in a state of hyperarousal and often re-experience the event that triggered their PTSD in the form of flashbacks or nightmares. They also experience mood alterations, trouble sleeping, and more.

It's estimated that up to 23 percent of U.S. veterans returning from Iraq and Afghanistan have PTSD.

It's notoriously difficult to treat PTSD. There is some evidence that SSRIs (antidepressants Zoloft or Paxil) may help treat PTSD. Additionally, psychotherapy including prolonged exposure and cognitive-processing therapy have proven effective in treating people with PTSD; however, many people end up dropping psychotherapy.

For people with PTSD, psychotherapy can be difficult because psychotherapy requires a patient to recall the triggering event. Some experts claim that MDMA administered before psychotherapy can reduce anxiety, reduce hypervigilance and increase relaxation all while keeping the patient motivated and engaged.

MDMA can increase empathy between a patient and therapist and inspire the patient to think about their problems in new and innovative ways thus contributing to insight.

According to Ben Sessa and David Nutt, authors of an article titled “Making a medicine MDMA,” during psychotherapy, MDMA helps “the patient to reach a position of empathic understanding and compassionate regard is part of their resolution and remittance of symptoms.”

The nuanced effects of MDMA are attributable to the drug's unique biochemical properties. Specifically, MDMA affects serotonin, dopamine and alpha-2 receptors as well as increasing the release of oxytocin. This release of oxytocin may facilitate bonding and empathy.

In a first-of-its-kind study, 85 percent of participants taking MDMA during a placebo-controlled study no longer were diagnosed with PTSD after three sessions of MDMA-assisted psychotherapy. Of note, this study was low power with few participants.

On a related note, Swiss researchers found that MDMA substantially reduced PTSD symptoms in people with treatment-resistant PTSD. Obviously, more research needs to be done to suss out the clinical benefits of MDMA administration among people with PTSD.

We should take a moment to further distinguish the illicit use of ecstasy with the clinical use of MDMA.

When people purchase ecstasy for recreational use, they typically use the drug excessively, expose themselves to potentially harmful adulterants and use other drugs in addition to MDMA cocaine, marijuana, and alcohol.

In clinical settings, limited doses of unadulterated MDMA are used for short-term adjuvant treatment during psychotherapy. In other words, buying ecstasy or off the street or in some club and using it to treat PTSD is a very bad idea.

Although MDMA shows promise as a treatment for PTSD, because of public opinion and government restrictions, MDMA may never be used to treat the disorder. Specifically, both the United States and the United Kingdom have banned the drug. Because MDMA is banned, it's very difficult to procure and test in clinical studies and unavailable for prescription.

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  • Nutt, David and Sessa, Ben. Making a Medicine MDMA. The British Journal of Psychiatry, 2015.
  • Sessa, Ben. Could MDMA Be Useful in the Treatment of Post-Traumatic Stress Disorder? Progress in Neurology and Psychiatry, 2011.


Ecstasy May Help Some With PTSD, but Risks Remain

MDMA (Ecstasy) Effects, Dangers & PTSD Research

From the WebMD Archives

By Steven Reinberg

HealthDay Reporter

TUESDAY, May 1, 2018 (HealthDay News) — People suffering from post-traumatic stress disorder (PTSD) might find some relief by using the popular party drug ecstasy, a small study suggests.

Technically, this synthetic drug is called 3,4-methylenedioxy-methamphetamine (MDMA) and it alters mood and perception. When tried with 26 veterans and first responders with PTSD, it helped many of them, investigators found.

“In research studies, MDMA has been shown to catalyze the therapeutic processing of traumatic memories and thereby relieve PTSD symptoms,” explained researcher Alli Feduccia, a clinical data scientist at MAPS Public Benefit Corp. in Santa Cruz, Calif.

The results of this new approach, which combines the drug with psychotherapy, were very encouraging, she said.

However, side effects were seen in the trial that included suicidal thoughts in some patients, and one psychiatrist expressed concern that taking MDMA long-term might trigger an addiction to the drug.

The U.S. Food and Drug Administration is now weighing whether to approve MDMA as a treatment for PTSD.

This new trial, along with five other phase 2 trials, were evaluated by the FDA, leading to a designation as a “breakthrough therapy,” Feduccia said.

“The FDA granted this designation comparing safety and efficacy results of MDMA-assisted psychotherapy to the two currently approved antidepressant medications, Paxil and Zoloft,” she said.

Feduccia said larger phase 3 trials of 200 to 300 patients are scheduled to begin this month.

“MDMA-assisted psychotherapy could become an FDA-approved treatment by 2021,” she said.

But one mental health expert said these latest results are too preliminary to consider MDMA a standard therapy for PTSD.

“MDMA might provide very useful help for patients who failed to respond to standard treatments for PTSD,” said Dr. Philip Cowen, a professor of psychopharmacology at the University of Oxford in England.

This, however, needs to be demonstrated in larger phase 3 studies, said Cowen, who wrote an editorial that accompanied the study. Both were published online May 1 in The Lancet Psychiatry journal.

“The take-home message,” Cowen said, “is to wait for the results of the latter studies, and if you have PTSD, don't try this at home.”

According to the researchers, up to 17 percent of first responders and 10 percent to 32 percent of military veterans suffer from PTSD, compared with 8 percent of the general population.

For the study, Feduccia and her colleagues gave three different doses of MDMA to 22 veterans, three firefighters and one police officer suffering from PTSD. Among the participants, 23 percent had tried ecstasy before.

Before starting MDMA, the participants had three sessions of psychotherapy to prepare them for the drug.

After their initial dose, the participants stayed overnight and were then followed by phone for seven days and given three additional psychotherapy sessions.

A month after the second session, more participants in high-dose groups no longer met diagnostic criteria for PTSD, compared with the low-dose group.

Side effects were seen regardless of dose. They included anxiety, headache, fatigue, muscle tension and insomnia.

In addition, passing moments of suicidal thoughts were seen, and one participant who had attempted suicide before was admitted to a hospital.

A month after the trial ended, all participants were offered one to two additional MDMA sessions followed by three psychotherapy sessions.

After a year, 16 participants still did not suffer from PTSD, but two had a new diagnosis of PTSD. In addition, 12 patients were also taking other psychiatric medications, the researchers noted.

Dr. Matthew Lorber, a psychiatrist at Lenox Hill Hospital in New York City, said that MDMA may help people with PTSD remember traumatic incidents and make them easier to deal with in therapy.

But he added that this small study can't assure the safety of MDMA when used long-term.

“To me, there is a risk of triggering addiction,” Lorber said.

This is especially worrying because people with PTSD are already at risk for addiction and suicide, he said.

SOURCES: Alli Feduccia, Ph.D., clinical data scientist, MAPS Public Benefit Corporation, Santa Cruz, Calif.; Philip Cowen, M.D., professor, psychopharmacology, department of psychiatry, University of Oxford, England; Matthew Lorber, M.D., psychiatrist, Lenox Hill Hospital, New York City; May 1, 2018,The Lancet Psychiatry, online Copyright © 2013-2018 HealthDay. All rights reserved.


MDMA for PTSD? How Ecstasy Ingredient Works in the Brain

MDMA (Ecstasy) Effects, Dangers & PTSD Research

The active ingredient in the drug ecstasy is set to be studied in large-scale clinical trials as a treatment for people with post-traumatic stress disorder, the New York Times reported on Nov. 29.

The ingredient, MDMA, has been shown to be effective in treating people with PTSD in smaller studies, which were sponsored by the Multidisciplinary Association for Psychedelic Studies (MAPS), a nonprofit organization that advocates for medical research on psychedelic substances.

But how does MDMA (3,4-methylenedioxy-N-methylamphetamine) work in the brain? And how could its effects help those with PTSD? [6 Party Drugs That May Have Health Benefits]

MDMA has several effects on the brain that appear to make the process of talking through past traumas a more effective way of dealing with them, said Dr. Michael Mithoefer, a psychiatrist in private practice in South Carolina and a clinical researcher who has worked on earlier studies of the drug.

Currently, psychotherapy, or talk therapy, is the “definitive treatment” for people with PTSD, Mithoefer told Live Science. There are drugs approved to treat PTSD, but they only target the symptoms, he added.

Still, in a large percentage of people, psychotherapy doesn't work well to treat the condition, Mithoefer said. Researchers think that MDMA could help people with PTSD by improving how they respond when they undergo psychotherapy, he said.

The effects of the drug seem to act as a catalyst for patients, helping them talk through and process their trauma, Mithoefer said. In other words, it's not the specific actions of MDMA in the brain that appear to treat PTSD, but rather that it seems to make psychotherapy more effective, he said.

Your brain on MDMA

MDMA causes a big increase in the levels of several neurotransmitters in the brain, the most predominant of which is serotonin, Mithoefer said. Serotonin is thought to contribute to feelings of well-being and happiness.

The drug also increases levels of certain hormones, including oxytocin and prolactin, Mithoefer said.

Oxytocin, which is sometimes referred to as the “love hormone,” is known to increase “affiliative behavior,” Mithoefer said. Increased levels of oxytocin make people more inclined to connect with others, he said.

Oxytocin has also been shown to affect how people respond to certain facial expressions, Mithoefer said.

For example, research has shown that people given oxytocin are less ly to interpret certain facial expressions as being angry or threatening, he said.

This can be helpful in therapy, particularly for people with PTSD, who tend to be hypervigilant and looking for threats, Mithoefer said. An increase in oxytocin may allow someone to be more trusting. [11 Interesting Effects of Oxytocin]

The other hormone, prolactin, can cause a “post-orgasmic state,” Mithoefer said. The hormone makes people feel more relaxed and increases their sense of satisfaction, he said.

Ultimately, MDMA seems to put patients in what researchers call the “optimal arousal zone,” Mithoefer said. If people are “hyperaroused” and flooded with anxiety and emotions, therapy doesn't tend to be effective, he said. Similarly, when a person is “hypoaroused,” effective therapy is difficult to achieve, he said.

But MDMA can give people several hours in the optimal arousal zone. “It's kind of the sweet spot where therapeutic change can happen,” Mithoefer said.

The drug has also been shown to decrease activity in the amygdala, an area of the brain associated with fear, and increase activity in the prefrontal cortex, which is where information processing takes place, Mithoefer said. People with PTSD have been shown to have increased activity levels in the amygdala, he said.

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Mithoefer and his colleagues have done brain-imaging studies on a small group of people with PTSD, comparing their brains before and after they took MDMA, but the results are still being analyzed, he said. The drug appears to have some effects in the brain that are opposite those linked to PTSD, he said.

Therapy in a controlled setting

People with PTSD are not ly going to feel “blissed out” when they take MDMA, Mithoefer said. In the trial that he conducted, patients did have positive experiences, but did not feel euphoric, he said.

The patients are processing the trauma that they went through, and even when they take MDMA, it is difficult and painful to do that, he said. But the drug seems to help them feel they can go through the process without feeling overwhelmed, he said.

If the drug does eventually win approval from the FDA, researchers aren't expecting it to be something patients simply go pick up at the pharmacy, Mithoefer said. Rather, it would be given at specialized clinics under direct supervision.

For example, in Mithoefer's trial, patients underwent several preparatory psychotherapy sessions before they were given the drug.

When they took MDMA, they did it under the supervision of therapists, who spent 8 hours with the patients. The patients then spent the night at the clinic, and were in touch with the therapists every day for the following week.

And before their next MDMA session, the therapists met with the patients several more times.

” any deep therapy, [the experience] can stir things up, so it's important to have proper support to process what comes up,” Mithoefer said. 

And MDMA does have negative side effects, Mithoefer said. In the short term, the drug can cause such symptoms as jaw-clenching and decreased appetite, he said. More serious side effects include increased blood pressure and pulse, he said.

MDMA increases blood pressure and pulse significantly, similar to fairly vigorous exercise, Mithoefer said. Because of this effect, people with heart disease were not included in previous studies, he said.

In addition, the researchers made sure to use pure MDMA in the studies. “On the street, you never know what you're getting,” Mithoefer said. While substances sold on the street under the names “ecstasy” and “molly” may contain MDMA, they frequently also contain unknown and/or dangerous adulterants, MAPS says.

Editor's Note: This article was updated on Dec. 6 to clarify that the researchers who worked with Mithoefer were not all psychiatrists, and that Mithoefer and his colleagues are analyzing brain-imaging studies on PTSD and MDMA.

Originally published on Live Science.