PTSDOpioid Use Disorder (OUD)Safety & Risk ManagementSubstance Use Disorders (SUD)MDMA

Making a medicine out of MDMA

This commentary (2015) examines how inappropriate, non-evidence-based, legislative restrictions of MDMA have failed to mitigate the harms of recreational ecstasy use but have effectively halted clinical research for therapeutic use. They urge the regulatory authorities to re-schedule MDMA and promote research for therapeutic uses within psychiatry.

Authors

  • David Nutt
  • Ben Sessa

Published

British Journal of Psychiatry
meta Study

Abstract

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.

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Research Summary of 'Making a medicine out of MDMA'

Introduction

Greer and colleagues frame the paper around the tension between MDMA’s historical association with recreational ecstasy and its potential as a clinical therapeutic. They note that media attention on rare harms from recreational use has hindered objective, evidence-based research into MDMA-assisted psychotherapy despite a quarter-century of epidemiological data indicating low morbidity and mortality associated with ecstasy and accumulating clinical data supporting MDMA’s therapeutic effects for conditions such as post-traumatic stress disorder (PTSD). The article aims to summarise the clinical history and emerging trial evidence for MDMA as a treatment adjunct, to outline its putative mechanisms and safety profile, and to argue for a regulatory change in the UK: moving MDMA from Schedule 1 (no recognised medical use) to Schedule 2 to enable and accelerate medically supervised research and clinical use for severe, treatment-resistant psychiatric disorders such as PTSD.

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Study Details

References (8)

Papers cited by this study that are also in Blossom

Subjective reports of the effects of MDMA in a clinical setting

Greer, G. R. · Journal of Psychoactive Drugs (1986)

423 cited
A window into the intoxicated mind? Speech as an index of psychoactive drug effects

Bedi, G., Cecchi, G. A., Slezak, D. F. et al. · Neuropsychopharmacology (2014)

89 cited
MDMA decreases the effects of simulated social rejection

Frye, C. G., Wardle, M. C., Norman, G. J. et al. · Pharmacology Biochemistry and Behavior (2014)

MDMA enhances emotional empathy and prosocial behavior

´dric, C., Hysek, M., Schmid, Y. et al. · Social Cognitive and Affective Neuroscience (2013)

MDMA alters emotional processing and facilitates positive social interaction

Wardle, M. C., De Wit, H. · Psychopharmacology (2014)

Effects of MDMA and Intranasal oxytocin on social and emotional processing

Kirkpatrick, M. G., Lee, R., Wardle, M. C. et al. · Neuropsychopharmacology (2014)

Cited By (8)

Papers in Blossom that reference this study

MDMA and memory, addiction, and depression: dose-effect analysis

Pantoni, M. M., Kim, J. L., Van Alstyne, K. R. et al. · Psychopharmacology (2022)

Debunking the myth of ‘Blue Mondays’: No evidence of affect drop after taking clinical MDMA

Sessa, B., Aday, J. S., Curran, H. V. et al. · Journal of Psychopharmacology (2021)

Psychedelic drugs-a new era in psychiatry?

Nutt, D. J. · Dialogues in Clinical Neuroscience (2019)

Dark Classics in Chemical Neuroscience: 3,4-Methylenedioxymethamphetamine

Dunlap, L. E., Andrews, A. M. · ACS Chemical Neuroscience (2018)

Safety pharmacology of acute MDMA administration in healthy subjects

Vizeli, P., Liechti, M. E. · Journal of Psychopharmacology (2017)

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Making a medicine out of MDMA — Research Summary & Context | Blossom