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MDMA (3,4-methylenedioxymethamphetamine) was originally synthesized and patented by the Merck chemical company in 1914. It was not explored for human use until the 1970–80s when there were published reports that it could be a useful catalyst to psychotherapy, in part because it often produced reduced anxiety and increased emotional openness. In 1985, in response to media attention to the recreational use of MDMA in the dance scene, the United States government placed MDMA in Schedule 1, making it illegal and declared unavailable for medical use. MDMA has complex pharmacological effects, including synaptic release of serotonin and other monoamines and triggering increased levels of oxytocin and other hormones. Research into the effects of MDMA is a rapidly evolving field, and the relationship between the physiological effects of MDMA and the range of experiences reported during MDMA sessions remains speculative. Controlled clinical trials of MDMA as a catalyst to psychotherapy have been under way since 2004, and most have been focused on posttraumatic stress disorder as a possible indication. After a series of international Phase 2 trials, results of the first Phase 3 trial were published in 2021 showing very robust improvements in posttraumatic stress disorder symptoms (measured by CAPS 5, the primary outcome measure), improvements in disability and depression scores, and a good safety record. A relatively nondirective method of therapy has been used in clinical trials that allows for each person’s unique therapeutic process to unfold in its own way without a pre-existing agenda. |
