MAPS is the official acronym for the Multidisciplinary Association for Psychedelic Studies, a U.S.-based non-profit research and educational organization, and they’re doing some exciting new research on the role psychedelics can play in the treatment of various mental health issues. For example, one of their ongoing projects involves answering the question as to how MDMA-assisted psychotherapy can help heal the psychological and emotional damage caused by sexual assault, war, violent crime, and other traumas. In other words, can MDMA and similar psychedelics be used as part of the treatment of PTSD (post-traumatic stress disorder)? Well, MDMA-assisted psychotherapy is a relatively new form of treatment that combines psychotherapeutic techniques with the administration of MDMA. So let’s focus on understanding MDMA for a moment now, shall we?
MDMA is a ring-substituted phenethylamine that produces anxiolytic and prosocial effects through release of the monoaminergic neurotransmitters with the greatest effect on serotonin, followed by norepinephrine and dopamine. In simpler terms, it helps alleviate feelings of anxiety while at the same time helping people desire to become more engaged with the world, and it does so by mostly acting on the serotonin receptors in our brain with a little work done on the norepinephrine and dopamine receptors as well. MDMA also has been shown to have the effect of temporarily decreasing activity in the left amygdala, the emotional center of our brain that is specifically involved in the processing of conscious emotions, while also increasing blood flow the prefrontal cortex in the brain. Other chemicals that MDMA works on are the neurohormones oxytocin and arginine vasopressin, hormones that act through our nervous system and are believed to be involved in increasing trust and attenuating, or lowering, reactivity to threatening cues. Taking into account all of these neurobiological effects of MDMA, it is unsurprising then to suggest that MDMA can increase compassion for self and others, reduce defenses and fear of emotional injury, while enhancing communication and capacity for introspection. Considering these factors in combination, MDMA can thus provide the opportunity for a correctional emotional experience in the context of psychotherapy.
To date in the MAPS clinical research program there have been 79 people exposed to MDMA and a total of 210 exposures. MAPS has published results showing clinically and statistically significant improvements in PTSD severity from 20 subjects treated in their first pilot study in the United States. Findings from the long-term follow-up of these subjects suggest that therapeutic benefits were sustained over an average of 41 months post-treatment. The second Phase 2 pilot study conducted in Switzerland in 12 subjects suggests clinically significant improvements in PTSD symptoms with a trend toward statistical significance. Long-term follow-up data 12 months later suggest that therapeutic benefits continued to increase in this subject population. Additionally, an initial pilot study was supported with two experimental sessions comparing full dose to 25 mg active placebo MDMA in Israel that treated five subjects, with no drug-related Serious Adverse Events. A dose-response study has also provided some support, in this case having MDMA-assisted psychotherapy for PTSD enrolled six subjects, with four receiving MDMA without producing any safety concerns and observing some symptom reduction.
MAPS current ongoing program consists of one Phase 1 study of MDMA-assisted psychotherapy in the U.S. and four Phase 2 MDMA/PTSD studies in the U.S., Canada and Israel that are actively recruiting. Ongoing and planned Phase 2 studies of MDMA-assisted psychotherapy for PTSD treatment are laying the groundwork for an End-of-Phase 2 meeting with FDA and Phase 3 multi-site MDMA/PTSD research studies. MAPS is now exploring new indications for this treatment. Due to similarities in symptom profiles and to reports from anecdotal research, they are conducting a protocol investigating changes in social anxiety experienced by autistic adults when using two sessions of MDMA-assisted therapy, interspersed with biweekly non-drug integration sessions.
As to my own personal opinion, I believe it to be quite fascinating that we are currently discovering a new method of treatment for a disorder that can be quite debilitating to those who suffer from it. The way our current society runs is a way that should and needs to be adjusted. People are all different, unique individuals that should be given unique, individual care plans adjusted to their own specific needs. In other words, people respond to things differently, and so we can’t continue treating them all the same way even if they’re lumped into the category of having PTSD and/or other disorders. Even the current psychopharmacological treatments we have today do not work on all individuals to the same extent. For example, I am currently on Prozac, which works for me, whereas one time before I had tried Lexapro, which did not work for me but is still shown to work for others. So to conclude, this is an advantageous opportunity to bring in a new line of treatment that might have a broader and deeper reach to those in our communities that suffer from PTSD.
MAPS,. (2015). MAPS: Multidisciplinary Association for Psychedelic Studies. Retrieved 24 June 2015, from http://www.maps.org