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Psychopharmacology Bulletin Jun 2021Post-traumatic stress disorder (PTSD) has become one of the most common psychiatric diagnosis in the United States specifically within the veteran population. The... (Review)
Review
Post-traumatic stress disorder (PTSD) has become one of the most common psychiatric diagnosis in the United States specifically within the veteran population. The current treatment options for this debilitating diagnosis include trauma-focused psychotherapies along with selective serotonin reuptake inhibitors (SSRI) and serotonin-norepinephrine reuptake inhibitors (SNRI). MDMA has recently been shown as a novel therapeutic agent with promisingly results in the treatment of PTSD. MDMA is a psychoactive compound traditionally categorized as a psychedelic amphetamine that deemed a Schedule I controlled substance in the 1980s. Prior to its status as a controlled substance, it was used by psychotherapists for an array of psychiatric issues. In more recent times, MDMA has resurfaced as a potential therapy for PTSD and the data produced from randomized, controlled trials back the desire for MDMA to be utilized as an effective pharmacologic therapy in conjunction with psychotherapy..
Topics: Adult; Hallucinogens; Humans; N-Methyl-3,4-methylenedioxyamphetamine; Psychotherapy; Stress Disorders, Post-Traumatic; Veterans
PubMed: 34421149
DOI: No ID Found -
Journal of Clinical Pharmacology Apr 2022This article discusses current literature on the use of 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy in the treatment of posttraumatic stress disorder... (Meta-Analysis)
Meta-Analysis Review
This article discusses current literature on the use of 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy in the treatment of posttraumatic stress disorder (PTSD). MDMA, the intended active ingredient in illicit Ecstasy or Molly products, is a psychedelic that causes an elevated mood, feeling of bonding, and increased energy. In MDMA-assisted psychotherapy, patients are subjected to 2 or 3 multihour sessions of therapy with a team of psychiatrists. The dosing of MDMA is used to allow the therapist to probe the underlying trauma without causing emotional distress. The use of MDMA-assisted psychotherapy treatment reduced patient's Clinician-Administered PTSD Scale (CAPS) scores from baseline more than control psychotherapy (-22.03; 95%CI, -38.53 to -5.52) but with high statistical heterogeneity. MDMA-assisted psychotherapy enhanced the achievement of clinically significant reductions in CAPS scores (relative risk, 3.65; 95%CI, 2.39-5.57) and CAPS score reductions sufficient to no longer meet the definition of PTSD (relative risk, 2.10; 95%CI, 1.37-3.21) with no detected statistical heterogeneity. While therapy was generally safe and well tolerated, bruxism, anxiety, jitteriness, headache, and nausea are commonly reported. While MDMA-assisted psychotherapy has been shown to be an effective therapy for patients with PTSD with a reasonable safety profile, use of unregulated MDMA or use in the absence of a strongly controlled psychotherapeutic environment has considerable risks.
Topics: Combined Modality Therapy; Humans; N-Methyl-3,4-methylenedioxyamphetamine; Psychotherapy; Stress Disorders, Post-Traumatic; Treatment Outcome
PubMed: 34708874
DOI: 10.1002/jcph.1995 -
Journal of Psychopharmacology (Oxford,... May 2021
Topics: Humans; N-Methyl-3,4-methylenedioxyamphetamine; Psychotherapy; Substance-Related Disorders
PubMed: 33938311
DOI: 10.1177/02698811211012604 -
CMAJ : Canadian Medical Association... Oct 2001"Ecstasy" (MDMA) and related drugs are amphetamine derivatives that also have some of the pharmacological properties of mescaline. They have become popular with... (Review)
Review
"Ecstasy" (MDMA) and related drugs are amphetamine derivatives that also have some of the pharmacological properties of mescaline. They have become popular with participants in "raves," because they enhance energy, endurance, sociability and sexual arousal. This vogue among teenagers and young adults, together with the widespread belief that "ecstasy" is a safe drug, has led to a thriving illicit traffic in it. But these drugs also have serious toxic effects, both acute and chronic, that resemble those previously seen with other amphetamines and are caused by an excess of the same sympathomimetic actions for which the drugs are valued by the users. Neurotoxicity to the serotonergic system in the brain can also cause permanent physical and psychiatric problems. A detailed review of the literature has revealed over 87 "ecstasy"-related fatalities, caused by hyperpyrexia, rhabdomyolysis, intravascular coagulopathy, hepatic necrosis, cardiac arrhythmias, cerebrovascular accidents, and drug-related accidents or suicide. The toxic or even fatal dose range overlaps the range of recreational dosage. The available evidence does not yet permit an accurate assessment of the size of the problem presented by the use of these drugs.
Topics: Amphetamines; Brain; Cardiovascular System; Humans; Liver; Mental Disorders; N-Methyl-3,4-methylenedioxyamphetamine; Neurotoxicity Syndromes
PubMed: 11599334
DOI: No ID Found -
Substance Use & Misuse 2005This study examines the relationship between MDMA (Ecstasy), sexual behavior, and sexual risk taking. The sample consisted of 98 current and former users of MDMA....
This study examines the relationship between MDMA (Ecstasy), sexual behavior, and sexual risk taking. The sample consisted of 98 current and former users of MDMA. Several strategies were utilized to recruit respondents and data were collected through in-depth interviews during 1997 and 1998. The majority of respondents had used MDMA during the 6-month period prior to the interview and a large percentage had consumed the drug on 100 occasions or more. Most respondents reported feelings of emotional closeness while consuming MDMA but without the desire for penetrative sex. Others, however, reported that MDMA increased sexual arousal and some respondents (in particular, gay and bisexual females) had used MDMA specifically for sexual enhancement. Sexual risk taking (e.g., having multiple partners, engaging in sex without a condom) was prevalent among respondents who did engage in sexual activity during MDMA episodes. Explanations for the findings are offered and implications for prevention/intervention are discussed.
Topics: Adolescent; Adult; Arousal; Emotions; Female; Hallucinogens; Health Surveys; Homosexuality; Humans; Male; Middle Aged; N-Methyl-3,4-methylenedioxyamphetamine; Risk-Taking; Sexual Behavior; Sexuality
PubMed: 16048828
DOI: 10.1081/JA-200066814 -
Lijecnicki Vjesnik 1997"Ecstasy" (3,4-methylenedioxymethamphetamine, MDMA) is a prototype of a class of amphetamine derivatives that selectively destroy serotonergic neurons in several brain... (Review)
Review
"Ecstasy" (3,4-methylenedioxymethamphetamine, MDMA) is a prototype of a class of amphetamine derivatives that selectively destroy serotonergic neurons in several brain regions of various species, including, most probably, humans. Due to its psychostimulant and psychodelic effects, "Ecstasy" has been increasingly abused, especially in association with the "Rave" (sub)culture. However, it is not an innocent stimulant. At least 30 cases of severe psychiatric disturbances (chronic psychoses, panic disorders, suicides) induced by recreational doses of "Ecstasy" have been reported during the past 10 years in periodicals included in MEDLINE data base. Moreover, about 70 cases of severe systemic intoxication in young, otherwise healthy individuals, characterized by hyperthermia, arrhythmias and blood pressure disturbances, disseminated intravascular coagulation, rhabdomyolysis and acute renal failure, have also been reported. Despite the fact that the patients were treated at the intensive care units, the mortality exceeded 40%. Furthermore, about 20 cases of acute or recurrent non-infective hepatitis, some of which with lethal outcome, have been described as well.
Topics: Hallucinogens; Humans; N-Methyl-3,4-methylenedioxyamphetamine; Substance-Related Disorders
PubMed: 9379824
DOI: No ID Found -
Medicine, Health Care, and Philosophy Sep 2020In the present paper, we discuss the ethics of compassionate psychedelic psychotherapy and argue that it can be morally permissible. When talking about psychedelics, we... (Review)
Review
In the present paper, we discuss the ethics of compassionate psychedelic psychotherapy and argue that it can be morally permissible. When talking about psychedelics, we mean specifically two substances: psilocybin and MDMA. When administered under supportive conditions and in conjunction with psychotherapy, therapies assisted by these substances show promising results. However, given the publicly controversial nature of psychedelics, compassionate psychedelic psychotherapy calls for ethical justification. We thus review the safety and efficacy of psilocybin- and MDMA-assisted therapies and claim that it can be rational for some patients to try psychedelic therapy. We think it can be rational despite the uncertainty of outcomes associated with compassionate use as an unproven treatment regime, as the expected value of psychedelic psychotherapy can be assessed and can outweigh the expected value of routine care, palliative care, or no care at all. Furthermore, we respond to the objection that psychedelic psychotherapy is morally impermissible because it is epistemically harmful. We argue that given the current level of understanding of psychedelics, this objection is unsubstantiated for a number of reasons, but mainly because there is no experimental evidence to suggest that epistemic harm actually takes place.
Topics: Chronic Disease; Compassionate Use Trials; Hallucinogens; Humans; Mental Disorders; N-Methyl-3,4-methylenedioxyamphetamine; Psilocybin; Psychotherapy; Terminal Care
PubMed: 32468195
DOI: 10.1007/s11019-020-09958-z -
European Journal of Pharmacology Jul 20213,4-methylenedioxymethamphetamine or MDMA (known as "ecstasy") is a recreational drug of abuse, popular worldwide for its distinctive psychotropic effects. Currently,... (Review)
Review
3,4-methylenedioxymethamphetamine or MDMA (known as "ecstasy") is a recreational drug of abuse, popular worldwide for its distinctive psychotropic effects. Currently, the therapeutic potential of MDMA in psychotherapy has attracted a lot of interest from the scientific community, despite the multitude of effects that this drug of abuse elicits on the human body. While neuronal effects have been the most studied, cardiovascular effects have also been described, as increased blood pressure and heart rate are the most recognizable. However, other effects have also been described at the cardiac (impaired cardiac contractile function, arrhythmias, myocardial necrosis and valvular heart disease) and vascular (vasoconstriction, disruption of vascular integrity and altered haemostasis) levels. Several mechanisms have been proposed, from the interaction with monoamine transporters and receptors to the promotion of oxidative stress or the activation of matrix metalloproteinases (MMPs). This review provides an overview of the cardiovascular implications of MDMA intake and underlying mechanisms, relevant when considering its consumption as drug of abuse but also when considering its therapeutic potential in psychiatry. Moreover, the risk/benefit ratio of the therapeutic use of MDMA remains to be fully elucidated from a cardiovascular standpoint, particularly in patients with underlying cardiovascular disease.
Topics: Animals; Blood Pressure; Blood Vessels; Cardiovascular System; Heart; Heart Rate; Humans; N-Methyl-3,4-methylenedioxyamphetamine
PubMed: 33971177
DOI: 10.1016/j.ejphar.2021.174156 -
The British Journal of Psychiatry : the... Jan 2015From its first use 3,4,-methylenedioxymethamphetamine (MDMA) has been recognised as a drug with therapeutic potential. Research on its clinical utility stopped when it...
From its first use 3,4,-methylenedioxymethamphetamine (MDMA) has been recognised as a drug with therapeutic potential. Research on its clinical utility stopped when it entered the recreational drug scene but has slowly resurrected in the past decade. Currently there is enough evidence for MDMA to be removed from its Schedule 1 status of 'no medical use' and moved into Schedule 2 (alongside other misused but useful medicines such as heroin and amphetamine). Such a regulatory move would liberate its use as a medicine for patients experiencing severe mental illnesses such as treatment-resistant post-traumatic stress disorder.
Topics: Humans; N-Methyl-3,4-methylenedioxyamphetamine; Stress Disorders, Post-Traumatic
PubMed: 25561485
DOI: 10.1192/bjp.bp.114.152751 -
ACS Chemical Neuroscience Oct 2018Better known as "ecstasy", 3,4-methylenedioxymethamphetamine (MDMA) is a small molecule that has played a prominent role in defining the ethos of today's teenagers and... (Review)
Review
Better known as "ecstasy", 3,4-methylenedioxymethamphetamine (MDMA) is a small molecule that has played a prominent role in defining the ethos of today's teenagers and young adults, much like lysergic acid diethylamide (LSD) did in the 1960s. Though MDMA possesses structural similarities to compounds like amphetamine and mescaline, it produces subjective effects that are unlike any of the classical psychostimulants or hallucinogens and is one of the few compounds capable of reliably producing prosocial behavioral states. As a result, MDMA has captured the attention of recreational users, the media, artists, psychiatrists, and neuropharmacologists alike. Here, we detail the synthesis of MDMA as well as its pharmacology, metabolism, adverse effects, and potential use in medicine. Finally, we discuss its history and why it is perhaps the most important compound for the future of psychedelic science-having the potential to either facilitate new psychedelic research initiatives, or to usher in a second Dark Age for the field.
Topics: Hallucinogens; History, 20th Century; History, 21st Century; Humans; N-Methyl-3,4-methylenedioxyamphetamine
PubMed: 30001118
DOI: 10.1021/acschemneuro.8b00155