How MDMA Could Transform Mental Health Treatment

How MDMA Could Transform Mental Health Treatment

Growing waitlists for therapists, antidepressants with low efficacy rates, rising anxiety levels—we need novel mental health treatments, and psychedelics seem the most promising solution. But people question whether they’re the saving grace we’ve been led to believe or if there’s more to using psychedelics for mental health than meets the eye. So, last but not least, we’re taking a deep dive into a psychedelic that sits in a class of its own: MDMA.

What Is MDMA?

MDMA (methyl​enedioxy​methamphetamine), also known as ecstasy or Molly on the street, acts as both a stimulant and a subtle hallucinogen. This unique effect makes it quite the popular party drug, illicitly frequenting clubs and festivals. Most people who take MDMA describe feeling happier and more empathetic, giving it the designation as an empathogen (or entactogen).

After someone takes MDMA, often in pill or capsule form, it takes about 30-45 minutes to feel its effects. A “trip” can last between three to six hours—though the exact length depends on how much someone takes and past experience with psychedelics. Responses to MDMA vary, though common side effects include nausea, cramping, and chills or sweating. Some people also feel the effects of MDMA throughout the following week and report more irritation, depression, and impulsiveness.

Recreational use of MDMA began in the 1960s, but by 1985 it was banned as a Schedule I substance, joining fellow psychedelics DMT and psilocybin. But that didn’t stop researchers or psychotherapists from studying its potential for mental health. Some psychotherapists were already incorporating MDMA into their practices and reporting breakthroughs with clients prior to its classification as an illegal substance. Then, in the early 1990s, the FDA permitted a small clinical trial that opened the door to more studies on MDMA.

How does MDMA differ from other psychedelics?

Psychedelics tend to fall under two categories: natural or synthetic and classic or dissociative.

Ketamine serves primarily as an anesthetic and a dissociative, synthetic psychedelic at sub-anesthetic levels. Unlike other psychedelics, it’s classified as a Schedule IV substance, meaning it can be prescribed for medical purposes. Ketamine can send someone into a dissociative or detached state and induce calm and relaxation.

Psilocybin is a natural, classic psychedelic that changes how someone perceives reality by activating the brain’s serotonin receptors. Scientists are still uncovering why this activation triggers hallucinations and its exact mechanisms.

MDMA, on the other hand, is a synthetic psychedelic that falls into its own category—neither classic nor dissociative. In the brain, MDMA causes a release of serotonin, dopamine, and norepinephrine, sending someone into both a state of activation and hallucination, unlike other psychedelics. However, how these neurotransmitters (brain chemicals) work to alter perception is still under investigation.

How does MDMA provide mental health relief?

Two robust, phase three studies involving people with severe PTSD showed MDMA’s remarkable potential in treating, and in some cases eliminating, debilitating symptoms. These findings helped MDMA receive the FDA’s “breakthrough therapy” distinction, like psilocybin, due to its promising results. The studies, performed by the Multidisciplinary Association for Psychedelic Studies (MAPS), paired MDMA with psychotherapy and saw marked symptom improvement in just 18 weeks with minimal side effects. Based on these findings, the group may soon seek FDA approval for therapeutic use.

Other, smaller studies on using MDMA for anxiety reported great potential as well, though they require replication on a much larger scale. And as noted in an earlier article, preparing and gathering funding for a clinical trial can take considerable time. Though, with an increased focus on new treatments for mental health, we may see interest in psychedelics continue to grow and, as a result, more trials funded.

Does MDMA affect women differently?

It’s likely, based on what we know about women’s hormones and ketamine’s varying effects on women, that MDMA may also impact women differently. Unfortunately, one of the most recent studies articulating MDMA’s variable impact was published over two decades ago. The results? MDMA does create a greater, more intense experience for women with reports of heightened hallucinations and overall “psychoactive effects.” Yet few studies further investigated its findings.

Outside the scientific realm, two articles—one from The Guardian and the other from Vice—though over five years old, cautioned women against using ecstasy or Molly due to its unique danger to women. The articles referred to illicit use, where pills are often cut with hazardous substances like fentanyl, but again raised the question of MDMA’s impact on women.

One possibility? MDMA may cause women to retain more water, and estrogen, one of our primary reproductive hormones, can stop our cells from releasing water. Combined, these factors can induce dangerous brain swelling.

Women must be aware that, even if psychedelics like MDMA are approved for therapeutic use, they may carry a greater risk for side effects. But we won’t know for certain until more women are included in clinical trials.

What’s the future of psychedelics like MDMA for mental health treatment?

Psychedelics have a long way to go until they achieve mainstream approval and acceptance. Each psychedelic requires more research and larger clinical trials to prove its efficacy for mental health treatment, though present results are quite promising.

It’s also important to note that while psychedelics alone provide some benefits, they are often most effective when paired with psychotherapy, in this case known as MDMA-assisted therapy. For example, MDMA, as evidenced by a recent finding from Johns Hopkins, may open a critical window that makes a person more receptive to change but requires additional guidance from a therapist for maximum effect. Even the remarkable PTSD studies included “three preparatory and nine integrative therapy sessions” that directly contributed to its success. However, the current therapist shortage in the US could become yet another barrier to the therapeutic use of MDMA.

MDMA and its fellow psychedelics may continue to prove a novel, effective treatment for mental health and receive FDA approval. If so, we hope more trials and studies investigate the evidence that psychedelics impact women differently.

FemmePharma does not advocate or endorse the use of illegal substances of any kind. The information contained in this article above is not meant to provide or replace medical advice.  Please consult your healthcare provider.

About the author
FemmePharma started as a pharmaceutical research and development company more than 20 years ago. We’ve been reinventing women’s healthcare ever since. Please consult your healthcare practitioner to decide which product best meets your needs.

Filed under: Stress & Anxiety

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