You may not know this, but ecstasy (MDMA) has been studied as a psychiatric medication. Yes, that’s right, that stuff kids take at raves. The stuff that makes you thirsty and fall in love to the person next to you. That stuff. And MDMA was shown effective in several psychiatric uses.
But research on MDMA (ecstasy) was curtailed in 1985 when the US government named it a class 1 drug (like heroin) over the objections of doctors. Psychiatric research on MDMA is gearing up again though and it has shown promise in treating post-traumatic stress disorder (PTSD) and possibly depression and anxiety.
What is Ecstasy (MDMA)?
The active substance in ecstasy is MDMA (3,4-methylenedioxymethamphetamine). However, when ecstasy is purchased on the street, MDMA is common mixed with methamphetamines and other drugs.
So, to be clear, this means that while taking MDMA in a clinical setting may pose limited risk, taking it illicitly is a different risk profile altogether. I do not recommend you buy ecstasy off the street to treat mental illness. (Particularly if you suffer from bipolar 1 or any psychotic symptoms.)
How Does Ecstasy (MDMA) Work?
The subjective effects of ecstasy (MDMA) are produced, in part, by a huge release of serotonin. This may be responsible for reducing the perception of threats and of negative emotions in others.
Ecstasy, MDMA, also increases levels of the neurohormones oxytocin, prolactin and cortisol. Oxytocin is thought to reduce feelings of fear and increase social affiliation and trust while cortisol is a stress hormone which may explain why some people experience anxiety while using MDMA.
How is Ecstasy (MDMA) Used in Psychiatry?
Interestingly, ecstasy is being used during psychotherapy and not as a psychopharmacological treatment, per se. MDMA is administered during elongated therapy sessions (8 hours) and patients work through emotions and memories that were impossible to handle beforehand. Two or three MDMA treatment sessions may be done with preparation therapy sessions beforehand and follow-up therapy sessions after.
Patients claim,
“. . . enhanced self-understanding [and] insight into personal patterns or problems, greater self-confidence or self-acceptance, lowered defenses [while] undergoing a therapeutic emotional process,” and “less negative thoughts or feelings.”
Studies on MDMA
Right now all the studies are on MDMA-treatment of post-traumatic stress disorder (PTSD) but look for other studies in the future. These studies on PTSD and ecstasy (MDMA) look extremely promising. Right now, several countries have completed phase one research and are onto phase two.
Risks of MDMA in Psychiatry
Risks vary depending on who you ask but in controlled, clinical use the risks of ecstasy (MDMA) appear to be minimal. While some worry about the effects on memory and cognition, some studies have shown there is no effect to these areas. There haven’t been enough participants in studies to make conclusive statements about MDMA risks.
My Thoughts on MDMA in Psychiatry
I’m very interested in such medications. MDMA works on the brain in a powerful way that other drugs do not. In this way ecstasy is unique and is hopeful for people with treatment-resistant disorders. I have a feeling that flooding the brain in this unusual way may be helpful in improving intractable disorders. This is mostly a hunch on my part, but I look forward to seeing what the future holds.
Reference
Psychiatric Times, Does MDMA Have a Role in Clinical Psychiatry? By Michael C. Mithoefer, MD, 06 May 2011
this is continued from last statement, accidentally hit the submit button, i hate toujch screens,
those emotions ……..bitterness, anger, resentments, that becomes void, and the uphoric side effects of the drug will make couples open up, most couples would go home and have sex for 8 hours, after a 4 hour counseling session.
this is where the addiction is the worst, when mdma is used for sexual purposes it is dangerous, using it for this reason just once can cause brain damage, the damage is not severe, it is subtle, the best way to put it……….sexually it opens a door/area of the brain, that wouldve never been opened before, the stimulating sexuall effects are through the roof, for the rest of that persons life, they will want to open that door again, the best way for use of the drug, is for patients to be unaware that theyve taken it, when people figured out what the drug was good for, it exoloded, and taking more than 1 pill results in high fever, deaths did occur, and fda crushed it, it was only to be used while at the therapists office during a session, prescriptions of the drug werent given like a script of vicodin, but there were doctors selling it outside of the practice or medical personell that were taking it from work,and distributing it at night clubs
the drug was origanally used in marraige counseling sessions, therapists would give a pill to husband/&wife, bitterness, resentmant, defencive and emotionally closed offf
I will say, having tried MDMA, and MDA and whatever else people cook to put into the drugs that we think we are purchasing, I don’t think it would be effective long term. People may hate me because they love the drug. I understand that. I hope that it is not legalized. MDMA messes up your ability to think properly, has high psychological addiction potential and I think it mirrors mania in some aspects.
This crosses a few more boundaries, but seemed relevant in the overall context.
http://www.huffingtonpost.com/ryan-grim/read-the-never-before-pub_b_227887.html#hoffmanjobsletter
It is the lack of research, and presumably funding, which arises from the prejudice. I think one the commentators earlier said that MDMA was a street drug and Ketamine is a horse tranquilizer showing an utter confusion between what a pharmacological agent is and the places it is sourced or the uses it is put to. Pah…
Richard,
With all due respect of the inventor of LSD, putting it in the water supply is such an ignorant and harmful idea that I find it hard to take anything else he seems seriously. Any drug couldn’t be used to ridiculously irresponsibly. Anyone want to put Prozac in the water? And make all the people with bipolar go manic? No, I didn’t think so.
There is prejudice, I’m just not sure how much that kind of idea helps.
– Natasha Tracy
Hold on a minute.
“If it helped people with a mental illness I would put (MDMA) in the water supply” Natasha Tracy (26th September)
I’m not and never have advocated putting anything in the water supply, I think the whole proposition is a little bit of a sidetrack. The issues of research, funding etc., on the other hand, matter.
Cheers, Richard x
Hi Richard,
Ah, foisted on my own glib hyperbole.
I thought it was pretty clear that I wasn’t serious about putting anything in the water supply but was making a point that if a medication helps it should be available to people. I got the distinct impression the inventor of LSD wouldn’t be so careful about it. (And he’s not the only one to really say “put it in the water supply.” For some reason people think just because they had some kind of mind-bending experience everyone else _should_ and _would_ have the same experience.)
But yes, you’re quite right, we’re veering off topic. I agree with you that funding is the issue and funding is very much a political issue and not a scientific one. We don’t put money into researching these drugs not because of any medical reason but simply because the government, in their infinite wisdom, decided to classify them in a certain way. And lord only knows why bureaucrats think they know better than doctors.
– Natasha Tracy
About twenty years ago, I was part of the rave scene in my area, and had access to very chemically pure MDMA. I am bipolar, but also have PTSD-and grew up with a bipolar mom, who did not raise me and when my sibs were born, expected me to raise them…all the while creating the illusion of closeness by innapropriately confiding to me her philandering and such. My mother to this day denies being bipolar or that her dad was or that my sibs are.
Needless to say, I was a very angry and confused girl in my teens and early twenties. My partner at the time and I also promoted parties, so we ended up buying a quantity of this MDMA….and held some back for personal use.
Our personal journey together was more therapy that either of us could have covered in 10 years. No, it wasn’t exactly clinical, but it was clear of common adulterants, and in a safe, trusting environment, and we talked about all kinds of things that would have usually been too embarrassed to. We did this a few times, and it helped me learn how to be different from what had been modeled for me, and it also helped me on the long road to identifying triggers for PTSD and learning to prevent them. It also helped me to not judge some people in those situations-they were doing their best..It just happened to suck, but it wasn’t about me.
If I hadn’t had those experiences, I may have figured all of that out another way, but with that partner, with the MDMA I learned all of that over less than a year. We didn’t stay together, but that was okay too. And everything I learned helped me be ready to be to step into my relationship/marraige of 16 years and taught me how to work through things in a reasonable way, a skill I could take with me from the experiences. I wouldn’t suggest you picked up some E from your local dealer, but I would reccomend agitating for more research and clinical trials. It should be our right.
D. Mae,
Thank-you for sharing your experience.
I know that some people who have used drugs report different ways of thinking but I really didn’t think the result was so persistent. But I don’t have personal experience in this area :)
I’d say you were pretty lucky to have such a supportive environment at the time. I suspect that’s a bit unusual.
And I agree, more research is needed. I think not researching such drugs is political, not scientific, and I don’t generally stand for such nonsense.
– Natasha Tracy
Yes, Natasha, that was an unusually supportive environment. I spent the years 13-nearly 21 with this young man in my life. If we weren’t a couple, we were still confidants, sometimes unbeknownst to out current partners, but always respected eachother’s relationships. We both had some serious problems, and both knew about the earlier research. Party kids with a scholarly bent…And my nerd is right there with you on the fact that putting MDMA on schedule 1 was a political decision, cause aren’t we the warringest country on drugs, even though we cleared Afghanistan to produce 90% of the opium crop. Look at the patchwork of decriminalization laws, yet you could still face federal charges for medical marijuana. Yeah, it’s political. I have a whole rant. I’ll save it for another time.
As for taking what you learn out of the situation with you, I think that’s variable and highly personal. I also think intentions make a difference here-as well as set and setting. There were time I took hallucinogens or MDMA and just had a nice day at the beach, but mostly I wanted those experiences to be learning experiences or opening up experiences, where I could take a time to expell some of the things in my life that had been so toxic.
For me, these new ways of thinking became part of a new version of myself…I didn’t yet know what I wanted to be, there was no model in my life yet, but I didn’t have so much baggage weighing me down. I unlearned the indoctrinated manipulative behaviors by calling out and having my partner call them out. Maybe these were lifelong lessons for me because I intended them to be and worked hard at building a new vision of myself. Maybe it’s just the way I tend to view my life holistically. I don’t know.
Hi D. Mae,
I think one of the key things you said is you worked hard. Recently, on Twitter, someone said that she “never worked that hard in her life” when she was in the hospital and trying to get better from a mental illness. And she succeeded. You worked hard on remaking yourself and used this as a tool. And obviously it helped you succeed as well.
And I agree, intention is important. Like with the research, the sessions are conducted with trained professionals to walk a person through the therapeutic process and not just left to trip on their own. In your case, you might have walked yourself through some things, but you definitely wouldn’t have if you hadn’t of specifically make the effort.
– Natasha Tracy
Thanks for pointing out the hard work, and acknowleging that sometimes we use the tool we have because we don’t have any others at that time. I didn’t actually figure out I was bipolar until I was 30, so that was essentially all of the treatment I had until then, excepting some truly unhelpful therapy as a child and teen. And another outstanding young man to work with me on my PTSD in some of the same ways, but also in other unconventional ways.
Yeah, I worked hard, but I have also been very lucky to have such really supportive partners.
Hi D. Mae,
Woking hard and being lucky is how many of us get here, I suspect.
– Natasha Tracy
Hi, Natasha:
In two words—-certainly NOT. As someone who used ecstacy I sufferred two grand mal seizues. The drug is not risk free even in it’s most potent form. This idea is much like the 60’s notion of giving acid in therapy. If the drug is illegal: there is a reaosn for this.MDMA is, of course, the purest form of the drug but is not risk free. One would be hard pressed to find a psychiatrist willing to go down this road. Lialibites on both ends.It is not safe.
Natalie
Hi Natalie,
I definitely respect anyone who has had experience with these drugs and their concerns over safety, but street drugs just aren’t the same as prescribed ones and I suspect you’re speaking of street drugs, no?
And drugs aren’t illegal for some good reason. Take alcohol. Alcohol causes more death and more domestic violence than _any_other_drug_ legal or illegal and yet any adult can consume as much as they want of it.
And another example, marijuana has never been shown to cause a single death, nor violence or crime and yet it remains illegal. Heroin, used in countries like the UK as an effective pain med.
My point is that most drugs are classified based on politics and nothing particularly substantial. I’m not saying people run out and buy street drugs because they are, well, street drugs and de facto rather risky, but the active chemicals themselves often have many useful applications.
And doctors, right now, are also interested in ketamine – another common street drug – for its use as a _rapid_ antidepressant.
The reason why doctors are interested in these compounds is because they are unique and provide hope for treatment-resistant individuals. And doctors have to see patients not get better, time after time, and they are looking for other effective treatments.
As for the risks of MDMA, at the end of the article they mention them but seizures don’t come up. But we don’t know enough about applying MDMA in a clinical setting to really say, so you could be right, that could be a risk.
– Natasha Tracy
MDMA is a street drug. It is the active ingredient in ecstasy. It has both hallucinogenic and amphetamine properties. Natalie
Also, ketamine is a horse tranqualizer. Very similiar in effect to MDMA. If they are going to go down this route they might as well try GHB, “the date rape drug”, because they all do the same thing: lower inhibitions and heighten the senses. I suppose someone who is a in a deep depression could benefit from these drugs and, later, find themselves buying them with their rent money.
If a drug brings your mood up, well, it will fall lower once the drug is gone.
It is not worth the risk.
Natalie
Yes, I know what ketamine is. It’s pharmacological method of action is somewhat different than MDMA as, like you said, its a tranquillizer (tranquillizers increase GABA, primarily and MDMA has a lot more to do with serotonin).
MDMA has very little addiction potential, FYI. Crystal meth, which often comes in ecstasy, on the other hand, is a different story.
Yes, the crash with MDMA is notable, but that’s why it’s only used with follow-up care and it’s only given two or three times.
The dose of ketamine they are using in studies actually has an antidepressant effect for about 6 days. Again, not that this is the same thing as taking a street drug.
I can definitely understand your reservations about these drugs but those are similar concerns shared around many drugs that are currently used safely. Caution, of course, is warranted and research is early.
– Natasha
Yes, I know. I use “MDMA” and “ecstasy” interchangeably in the article because the reference article does, for ease of reading and for ease of Google.
Of course, in clinical practice straight MDMA is used.
And while ecstasy is available on the street I wouldn’t quite call it the same thing as it comes in unknown purities with unknown contaminates.
– Natasha
Well, the two should not be used interchangeably.
Just my thoughts.
Natalie,
Completely reasonable.
– Natasha Tracy
“f the drug is illegal: there is a reaosn for this”
of course there is reason. Politics. Lobby. Somebody decided, and not necesarily somebody who knows there best.
I live in Czech Republic… Czech Republic and Slovakia, who have been fedaration until not so loing ago have very different laws regarding subtances regulation. Melatonin is ILLEGAL in Czech republic, legal in Slovakia (although risk of smuggling melatonin over border are significantly lesser). But marijuana is decriminalized here, while illegal in Slovakia…. we have laugh that on some OTC stuff there is different maximum dose indicated for Czech and Slovaks. Yes, it’s all for reason and makes perfect sense……… *sarcasm* Point? That is how politics work.
People recommended me LSD as something that could be helpful, but I react pretty strongly to chemicals, so not sure if it would “work” for me.
Hi VenusH,
I would agree with you that _some_ drugs are made illegal for primarily political motivation and yes, it would be better to legalize some of them but really, no one out there needs, or should have access to, crack.
And as for LSD, it’s your call what to put into your body but I wouldn’t recommend street drugs – you never know what is in them and you’re seriously rolling the dice with something like LSD. People _without_ mental illness histories have very bad reactions to that drug and have lifelong consequences because of using it.
– Natasha Tracy
Hi Natasha, I think my dry sarcasm passed you by – it wasn’t aimed at you, but at the way these things have been handled – I’m well aware of everyone from Hoffman to Leary to Kesy and take these to be the merely the faces behing a lot of otherwise annonymised research into LSD…and no doubt MDMA.
What I was, unsuccessfully, trying to say was that it is the very status of MDMA or LSD as proscribed ‘drugs’ as opposed to nice pharmaceutical medicines which causes the problem – both in patient and public perception. And, I would add that the sound of “very specialised personnel (which conjours up the image in my mind of white coated experts) makes things worse not better – our mental health is found in the community not the laboratory or the clinic. The prejudice I identified can be shrugged off by you or I, but unfortunately that does not make it go away.
Anyway, sorry for writing stuff that was deficient in its communicative potential, as I had only intended to be sympathetic to your point.
All the best.
bipolarxplorer
Hi bipolarxplorer,
Yes, dry sarcasm is difficult to communicate online. I have my own difficulties with such things. It’s why emoticons were invented, even though, truth be told, I rather hate those too.
I suspect “specialized personnel” does involve at least one person in a white coat. As Natalie said, things, like seizures, can occur so whit coats are handy things to have.
It’s good that you can find your bipolar answers in the community but for me, it will likely always be a clinic to some degree. And, make no mistake abut it, if I were to try some drastic mind-altering chemical like MDMA it would be under professional supervision only. My brain is far too sensitive to go any other way.
– Natasha Tracy
Hi BipolarExporer,
Well, LSD has been researched too and may also be promising. It’s used in a similar way.
And yes, social culture does make a difference which is why the MDMA is only administered in very strict circumstances and with specialized personnel.
And prejudice? If it helped people with a mental illness I would put in the water supply. :) Prejudice doesn’t concern me in the least.
– Natasha Tracy
Well I never, it’ll be back to the LSD next! Seriously, I take the view that it all depends on the social construction (in the widest sense – background culture, preconceptions, scene, setting, expectation – of all those taking part) and that the sheer volume of prejudice surrounding illegal drugs is part of this and complicates things hugely.