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MDMA

An honest look at the risks and benefits of MDMA

December 6, 2021 / Articles, Background articles, MDMA, Publications, Research, Safety / By

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Addiction, one of the most important peer-reviewed journals on drug use and abuse, has published the results of a study regarding the use of recreational ecstacy use and potential cognitive damage – which turned out to be absent. The study is unique in that it compared ecstacy users with minimal to no other drug use and non-drug users from the same dance scene.

For years it has been assumed that cognitive skills such as learning and memory would be damaged by heavy ecstacy use. But previous studies always used subjects that also used other drugs, so it could not be determined whether the damage was due to ecstacy use or use of other drugs. This study offers a new light on the matter.

The same day, O Magazine published an article on MAPS’ study of the use of MDMA in psychotherapy for people suffering from PTSD. Sarah, who has suffered from PTSD for twenty years, tells the reader about her experiences with MDMA-assisted psychotherapy for PTSD. You can read the full article here.

MDMA-Assisted Psychotherapy Using Low Doses in a Small Sample of Women with Chronic Posttraumatic Stress Disorder

September 8, 2011 / Anxiety disorders / PTSD, MDMA, Papers, Psychiatry, Psychology, Psychopharmacology, Psychotherapy, Publications / By / , , , ,

Abstract

The purpose of this study was to investigate the safety of different doses of MDMA-assisted psychotherapy administered in a psychotherapeutic setting to women with chronic PTSD secondary to a sexual assault, and also to obtain preliminary data regarding efficacy. Although this study was originally planned to include 29 subjects, political pressures led to the closing of the study before it could be finished, at which time only six subjects had been treated. Preliminary results from those six subjects are presented here. We found that low doses of MDMA (between 50 and 75 mg) were both psychologically and physiologically safe for all the subjects. Future studies in larger samples and using larger doses are needed in order to further clarify the safety and efficacy of MDMA in the clinical setting in subjects with PTSD.

Bouso, J. C., Doblin, R., Farré, M., Alcázar, M. Á., & Gómez-Jarabo, G. (2008). MDMA-assisted psychotherapy using low doses in a small sample of women with chronic posttraumatic stress disorder. Journal of psychoactive drugs, 40(3), 225-236., 10.1080/02791072.2008.10400637
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In Vivo Imaging of Cerebral Serotonin Transporter and Serotonin 2A Receptor Binding in MDMA and Hallucinogen Users

June 6, 2011 / Ayahuasca, Cacti / Mescaline, DMT, LSD, MDMA, Mushrooms / Psilocybin, Neuroscience, Other subjects, Papers, Psychology, Psychopharmacology, Publications, Salvia / Salvinorin A / By / , , , , , ,

Abstract

Context:
Both hallucinogens and 3,4-methylenedioxy-methamphetamine (MDMA or “ecstasy”) have direct agonistic effects on postsynaptic serotonin 2A receptors, the key site for hallucinogenic actions. In addition, MDMA is a potent releaser and reuptake inhibitor of presynaptic serotonin.

Objective:
To assess the differential effects of MDMA and hallucinogen use on cerebral serotonin transporter (SERT) and serotonin2Areceptor binding.

Design:
A positron emission tomography study of 24 young adult drug users and 21 nonusing control partici-pants performed with carbon 11 (11C)–labeled 3-amino-4-[2-[(di(methyl)amino)methyl]phenyl]sulfanylbenzo-nitrile (DASB) and fluorine 18 (18F)–labeled altanserin, respectively. Scans were performed in the user group after a minimum drug abstinence period of 11 days, and the group was subdivided into hallucinogen-preferring users (n = 10) and MDMA-preferring users (n = 14).

Participants:
Twenty-four young adult users of MDMA and/or hallucinogenic drugs and 21 nonusing controls.

Main Outcome Measures:
In vivo cerebral SERT and serotonin 2A receptor binding.

Results:
Compared with nonusers, MDMA-preferring users showed significant decreases in SERT nondisplaceable binding potential (neocortex, −56%; pallidostriatum, −19%; and amygdala, −32%); no significant changes were seen in hallucinogen-preferring users. Both cortical and pallidostriatal SERT nondisplaceable binding potential was negatively correlated with the number of life-time MDMA exposures, and the time of abstinence from MDMA was positively correlated with subcortical, but not cortical, SERT binding. A small decrease in neocortical serotonin 2A receptor binding in the serotonin 2A receptor agonist users (both user groups) was also detected.

Conclusions
We found evidence that MDMA but not hallucinogen use is associated with changes in the cerebral presynaptic serotonergic transmitter system. Because hallucinogenic drugs primarily have serotonin 2A receptor agonistic actions, we conclude that the negative association between MDMA use and cerebral SERT binding is mediated through a direct presynaptic MDMA effect rather than by the serotonin 2A agonistic effects of MDMA. Our cross-sectional data suggest that subcortical, but not cortical, recovery of SERT binding might take place after several months of MDMA abstinence.

Erritzoe, D., Frokjaer, V. G., Holst, K. K., Christoffersen, M., Johansen, S. S., Svarer, C., … Knudsen, G. M. (2011). In Vivo Imaging of Cerebral Serotonin Transporter and Serotonin 2A Receptor Binding in 3,4-Methylenedioxymethamphetamine (MDMA or “Ecstasy”) and Hallucinogen Users. Archives of General Psychiatry, 68(6), 562-576. http://dx.doi.org/10.1001/archgenpsychiatry.2011.56
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Residual neurocognitive features of long-term ecstasy users with minimal exposure to other drugs

February 15, 2011 / MDMA, Neuroscience, Other subjects, Papers, Psychology, Psychopharmacology, Publications, Safety, Toxicology / By / , , , , ,

Abstract

Aims: In field studies assessing cognitive function in illicit ecstasy users, there are several frequent confounding factors that might plausibly bias the findings toward an overestimate of ecstasy-induced neurocognitive toxicity. We designed an investigation seeking to minimize these possible sources of bias.

Design: We compared illicit ecstasy users and non-users while (1) excluding individuals with significant life-time exposure to other illicit drugs or alcohol; (2) requiring that all participants be members of the ‘rave’ subculture; and (3) testing all participants with breath, urine and hair samples at the time of evaluation to exclude possible surreptitious substance use. We compared groups with adjustment for age, gender, race/ethnicity, family-of-origin variables and childhood history of conduct disorder and attention deficit hyperactivity disorder. We provide significance levels without correction for multiple comparisons.
Setting: Field study.
Participants: Fifty-two illicit ecstasy users and 59 non-users, aged 18–45 years.
Measurements: Battery of 15 neuropsychological tests tapping a range of cognitive functions.
Findings: We found little evidence of decreased cognitive performance in ecstasy users, save for poorer strategic self-regulation, possibly reflecting increased impulsivity. However, this finding might have reflected a pre-morbid attribute of ecstasy users, rather than a residual neurotoxic effect of the drug. Conclusions In a study designed to minimize limitations found in many prior investigations, we failed to demonstrate marked residual cognitive effects in ecstasy users. This finding contrasts with many previous findings—including our own—and emphasizes the need for continued caution in interpreting field studies of cognitive function in illicit ecstasy users.
Halpern, J. H., Sherwood, A. R., Hudson, J. I., Gruber, S. Kozin, D., & Pope Jr., H. G. (2011). “Residual neurocognitive features of long-term ecstasy users with minimal exposure to other drugs. Addiction, 106(4), 777-786. http://dx.doi.org/10.1111/j.1360-0443.2010.03252.x
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Is Ecstasy an “Empathogen”? Effects of ±3,4-Methylenedioxymethamphetamine on Prosocial Feelings and Identification of Emotional States in Others

December 15, 2010 / MDMA, Other subjects, Papers, Psychology, Psychopharmacology, Publications / By / , ,

Abstract

Background: Users of MDMA (“ecstasy”) report that the drug produces unusual psychological effects, including increased empathy and prosocial feelings. These “empathogenic” effects are cited as reasons for recreational ecstasy use and also form the basis for the proposed use of MDMA in psychotherapy. However, they have yet to be characterized in controlled studies. Here, we investigate effects of MDMA on an important social cognitive capacity, the identification of emotional expression in others, and on socially relevant mood states.

Methods: Over four sessions, healthy ecstasy-using volunteers (n = 21) received MDMA (.75, 1.5 mg/kg), methamphetamine (METH) (20 mg), and placebo under double-blind, randomized conditions. They completed self-report ratings of relevant affective states and undertook tasks in which they identified emotions from images of faces, pictures of eyes, and vocal cues.

Results: MDMA (1.5 mg/kg) significantly increased ratings of feeling “loving” and “friendly”, and MDMA (.75 mg/kg) increased “loneliness”. Both MDMA (1.5 mg/kg) and METH increased “playfulness”; only METH increased “sociability”. MDMA (1.5 mg/kg) robustly decreased accuracy of facial fear recognition relative to placebo.

Conclusion: The drug MDMA increased “empathogenic” feelings but reduced accurate identification of threat-related facial emotional signals in others, findings consistent with increased social approach behavior rather than empathy. This effect of MDMA on social cognition has implications for both recreational and therapeutic use. In recreational users, acute drug effects might alter social risk-taking while intoxicated. Socioemotional processing alterations such as those documented here might underlie possible psychotherapeutic benefits of this drug; further investigation of such mechanisms could inform treatment design to maximize active components of MDMA-assisted psychotherapy.

Bedia, G., Hymana, D., & de Wit, H. (2010). Is Ecstasy an “Empathogen”? Effects of ±3,4-Methylenedioxymethamphetamine on Prosocial Feelings and Identification of Emotional States in Others. Biological Psychiatry, 68(12), 1134-1140. http://dx.doi.org/10.1016/j.biopsych.2010.08.003
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Trouw: Ecstasy against PTSD

December 6, 2021 / Articles, Events, MDMA, Publications, Research / By

In anticipation of our conference, which took place last weekend, newspaper Trouw published an article in which Joost Breeksema (president of the OPEN Foundation) is interviewed. Today the newspaper writes about the research into the treatment of PTSD with MDMA that Peter Oehen presented at the conference. 

Trouw: “The study showed that patients, after the treatment with MDMA, experienced less anxiety and were better able to tolerate negative emotions. Moreover, they experienced less emotional and physical pain.”

DEA approves MDMA/PTSD study

December 6, 2021 / Articles, MDMA, Publications, Research / By

More news on the subject of research: on august 27th 2010 the DEA, an American government organisation in charge of the laws regarding ‘controlled substances’ in the US, has approved a study regarding the effects of MDMA on war veterans suffering from post-traumatic stress syndrome. MAPS can go ahead with the research, which will cost $500,000 and will take the good part of two years. Most of the budget still has to be found, but it’s a step in the right direction!

On the OPEN conference (october 23/24) you can hear more about these kinds of studies. Click here for more information.

Psychometric Evaluation of the Altered States of Consciousness Rating Scale (OAV)

August 31, 2010 / Ketamine, MDMA, Mushrooms / Psilocybin, Other subjects, Papers, Psychology, Publications / By / , ,

Abstract

This paper describes a refinement of Dittrich’s Altered States of Consciousness questionnaire. This questionnaire is among the most widely used self-report questionnaires for retrospectively assessing subjective experiences induced by psychedelics and other psychoactive drugs. Using data collected over many years from 591 human volunteers, they factored the original four subscales developed by Dittrich into 11 new subscales. This new improved instrument will play an important role in more precisely defining the qualitative subjective experiences in research with psychedelics.

Background: The OAV questionnaire has been developed to integrate research on altered states of consciousness (ASC). It measures three primary and one secondary dimensions of ASC that are hypothesized to be invariant across ASC induction methods. The OAV rating scale has been in use for more than 20 years and applied internationally in a broad range of research fields, yet its factorial structure has never been tested by structural equation modeling techniques and its psychometric properties have never been examined in large samples of experimentally induced ASC.

Methodology/Principal Findings: The present study conducted a psychometric evaluation of the OAV in a sample of psilocybin (n = 327), ketamine (n = 162), and MDMA (n = 102) induced ASC that was obtained by pooling data from 43 experimental studies. The factorial structure was examined by confirmatory factor analysis, exploratory structural equation modeling, hierarchical item clustering (ICLUST), and multiple indicators multiple causes (MIMIC) modeling. The originally proposed model did not fit the data well even if zero-constraints on non-target factor loadings and residual correlations were relaxed. Furthermore, ICLUST suggested that the ‘‘oceanic boundlessness’’ and ‘‘visionary restructuralization’’ factors could be combined on a high level of the construct hierarchy. However, because these factors were multidimensional, we extracted and examined 11 new lower order factors. MIMIC modeling indicated that these factors were highly measurement invariant across drugs, settings, questionnaire versions, and sexes. The new factors were also demonstrated to have improved homogeneities, satisfactory reliabilities, discriminant and convergent validities, and to differentiate well among the three drug groups.

Conclusions/Significance: The original scales of the OAV were shown to be multidimensional constructs. Eleven new lower order scales were constructed and demonstrated to have desirable psychometric properties. The new lower order scales are most likely better suited to assess drug induced ASC.

Studerus, E., Gamma, A., & Vollenweider, F. X. (2010). Psychometric Evaluation of the Altered States of Consciousness Rating Scale (OAV). PLoS ONE, 5(8). http://dx.doi.org/10.1371/journal.pone.0012412
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Eerste MDMA/PTSS trial afgerond

December 2, 2021 / Artikelen, Dutch, MDMA, Onderzoek / By

Uit de eerste afgeronde klinische trial op het gebied van de behandeling van PTSS (posttraumatische stressstoornis) met MDMA is gebleken dat MDMA bij patiënten voor een verlichting van hun klachten kan zorgen: meer dan 80 procent van de deelnemers voldeden na de behandeling niet meer aan de voorwaarden voor PTSS zoals deze in de DSM-IV (het meest recente ‘handboek’ voor mentale stoornissen) zijn vermeld.

Het onderzoek richtte zich op twee psychotherapie-sessies van acht uur met een tussenperiode van drie tot vijf weken. Een deel van de proefpersonen kreeg MDMA, de rest kreeg een placebo. Ook ondergingen alle deelnemers wekelijks ‘normale’ psychotherapie. Tien van de twaalf mensen die MDMA kregen, reageerden positief op de behandeling.

Na twee maanden kregen de mensen uit de controlegroep de mogelijkheid om alsnog deel te nemen aan de behandeling, waarin ze nu wel MDMA zouden krijgen. Zeven van de acht mensen uit de controlegroep kozen hiervoor, met positieve resultaten. Het lijkt er dus op dat er een doorbraak is geweest in het onderzoek naar psychotherapie met behulp van MDMA, waardoor er ruimte is voor nieuwe onderzoeken – dat is goed nieuws!

First MDMA/PTSD trial finished

December 6, 2021 / Articles, Background articles, MDMA, Publications, Research / By

The first finished clinical trial regarding PTSD (post-traumatic stress disorder) and the treatment of that disorder with MDMA has indicated that MDMA can relieve PTSD symptoms: over 80 percent of the participants no longer met the requirements for PTSD as they are defined in DSM-IV (the most recent ‘handbook’ for mental disorders).

The study focused on two therapy sessions of eight hours with a period of three to five weeks in between. Some of the participants were given MDMA, the others were given a placebo. All participants also took part in weekly ‘normal’ psychotherapy sessions. Ten out of the twelve people that were given MDMA reacted positively on the treatment.

After two months, the people from the control group were given the opportunity to take part in the real treatment, where they would be given MDMA this time. Seven out of eight people from the control group chose to do this, with positive results. It seems as if there has been a breakthrough in researching psychotherapy with the aid of MDMA, making room for new studies – which is good news!

14 May - Psychedelics & Psychosis with Phoebe Friesen and Dirk Corstens

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