Later On

A blog written for those whose interests more or less match mine.

Ecstasy as a treatment of PTSD

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Interesting post by Mark Kleiman:

The first published results for MDMA-assisted therapy in the treatment of Post-Traumatic Stress disorder are now in, and they’re eye-opening.

It’s only a 20-patient pilot study, and MDMA functions as an adjunct to therapy, not as a pure pharmacological agent such as an SSRI or an anti-psychotic, raising the question about whether the results would generalize to other therapists.

Still, in a patient group with a median of 19 years of treatment-refractory post-traumatic stress disorder, getting 10 out of 12 of them to the point where they no longer meet diagnostic criteria constitutes an unprecedented success rate. Given the PTSD burden from Iraq and Afghanistan, this research – long blocked due to prejudice against MDMA (the active agent in street “ecstasy”) – now deserves a move to the front burner. It shouldn’t need to rely on private contributions, and it should be free of petty bureaucratic harassment and foot-dragging.

It should also be free of the hypervigilance of Institutional Review Boards. The notion that someone needs to be in a hospital for 24 hours after a single controlled dose of MDMA is flat-out absurd. And there’s simply no evidence of neurotoxic effects at the dosages and frequencies involved.

And from the comments to his post:

The full paper (PDF) is available.

And also this comment by Ed Whitney:

MDMA is off-patent, and therefore there is no incentive for Big Pharma to fund a study, especially for a drug that will be administered only a few times, and not daily for life. Whether there are implications for the adequacy of “the free marketplace” alone to create innovations is left as a debating point.

BTW, I did look at all the changes to the protocol that were posted on the clinicaltrials.gov website for this trial, but did not see anything relating to changes in inclusion criteria. They are still a mystery to me.

On NPR’s “Fresh Air” program recently, the guest was a psychiatrist who was lamenting the fact that only a small number of psychiatrists today are even offering psychotherapy to their patients. This too has some bearing on the problem at hand. Psychiatry has become a discipline of medication management. Sad but true, but a psychiatrist who can see four patients an hour is more “productive” than a psychiatrist who can see only one.

Written by Leisureguy

24 July 2010 at 10:45 am

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