Talk:MDMA

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Evidence for PTSD efficacy

The research section currently states:

MDMA has been claimed to be useful in treating post-traumatic stress disorder, but such claims are not backed by good evidence.[181]

Source 181 actually states:

It has been suggested that MDMA, for example, possesses characteristics that make it uniquely useful for the treatment of PTSD [122]; the same has been argued for ibogaine in the treatment of SUD [42]. The high heterogeneity of the articles included in this review do not provide sufficient evidence to establish these relations

This is not the same thing. The study does not claim that the evidence of usefulness is limited, but that the evidence for unique usefulness is limited.

Moreover, a newer review that is more specific to the topic and includes more trials states the following:

The evidence for MDMA in combination with psychotherapy as a PTSD treatment was ranked "moderate"

I propose that the last sentence in the research section states:

MDMA in combination with psychotherapy has been studied as a treatment for PTSD, and four clinical trials provide moderate evidence in support of this

Juniusbrutus (talk) 04:10, 21 February 2021 (UTC)

 Done the newer review should also be cited, right? You didn't make that clear in your request, but if you think it should be cited in the article, feel free to re-open. Elliot321 (talk | contribs) 17:08, 21 February 2021 (UTC)

Semi-protected edit request on 22 February 2021

It is misrepresentative to state only that MDMA is primarily used for recreational purposes in the introductory sentence. Please change "primarily used for recreational purposes" to "primarily used for recreational and therapeutic purposes". It is also worth changing the end of the introduction: "MDMA is illegal in most countries and, as of 2018, has no approved medical uses." Afterwards, please add, "However, in 2017 the FDA granted breakthrough therapy designation for its use with psychotherapy for PTSD." 209.6.143.81 (talk) 21:23, 22 February 2021 (UTC)

 Not done. Please provide a reliable source showing that MDMA is actually used for therapeutic uses. Just a designation does not count. ◢  Ganbaruby!  (Say hi!) 08:17, 23 February 2021 (UTC)

Semi-protected edit request on 25 February 2021

MDMA was not first synthesized by Merck, it was first synthesized by Alexander “Sasha” Shulgin. 75.142.234.192 (talk) 06:25, 25 February 2021 (UTC)

 Not done: please provide reliable sources that support the change you want to be made. – robertsky (talk) 08:58, 25 February 2021 (UTC)

Semi-protected edit request on 30 June 2021

In the last sentence of the summary, change "In the US the Food And Drug Association is currently evaluating the drug for clinical use.[23]" to "In the US the Food and Drug Administration is currently evaluating the drug for clinical use.[23]"

For clarity, "Food And Drug Association" should be "Food and Drug Administration"

Verified through cited article IsbenTakesTea (talk) 16:53, 30 June 2021 (UTC)

That whole sentence could do with a rewrite. It makes it sound like the FDA is driving the change when it's actually in clinical trial for therapeutic use. That source should instead be used to provide additional information in the Research and Medical sections. I plan on taking a closer look at this later, but if someone else patrolling edit requests wants to take a stab at it, go for it. Living Concrete (talk) 17:22, 30 June 2021 (UTC)

 Done typo fixed by Ignatios2000 ScottishFinnishRadish (talk) 17:50, 30 June 2021 (UTC)

References

Semi-protected edit request on 25 September 2021

Under title Research: Change - A 2014 review of the safety and efficacy of MDMA as a treatment for various disorders, particularly PTSD, indicated that MDMA has therapeutic efficacy in some patients;[62] however, it emphasized that issues regarding the controlability of MDMA-induced experiences and neurochemical recovery must be addressed.[62] The author noted that oxytocin and d-cycloserine are potentially safer co-drugs in PTSD treatment, albeit with limited evidence of efficacy.[62] This review and a second corroborating review by a different author both concluded that, because of MDMA's demonstrated potential to cause lasting harm in humans (e.g., serotonergic neurotoxicity and persistent memory impairment), "considerably more research must be performed" on its efficacy in PTSD treatment to determine if the potential treatment benefits outweigh its potential to harm to a patient.[14][62]

To: A Systematic Review and Meta-Analysis published in May 2021.

{https://www.cureus.com/articles/58217-the-efficacy-of-mdma-34-methylenedioxymethamphetamine-for-post-traumatic-stress-disorder-in-humans-a-systematic-review-and-meta-analysis#references} Findings show promising evidence for the potential therapeutic use of MDMA alongside psychotherapy in the treatment of PTSD. The pharmacological profile of MDMA may provide direction for future drug developments to treat patients with treatment-resistant psychiatric disorders.

Studies have shown the potential benefits in clinical trials for post-traumatic stress disorder (PTSD). A larger amount of data has been provided for the push in support of MDMA-assisted psychotherapy in these patients.

Studies on psychiatric treatments for mental illness have shown that there is a general dose-dependent benefit of MDMA in assisted psychotherapy, where the Clinician-Administered PTSD Scale (CAPS) total scores at the primary endpoint showed changes proportional to the dosage amount { https://dx.doi.org/10.1177/0269881118806297?utm_medium=email&utm_source=transaction} There are, however, adverse health effects with recreational use due to overdosing, such as hypertension, faintness, panic attacks, and, in severe cases, loss of consciousness and seizures [1]. There is still much to be learned about MDMA’s therapeutic dosing effect and its support with psychotherapy treatment of PTSD.

When patients are exposed to occurrences that trigger traumatic events while under the therapeutic treatment, this enables them to reactivate their fear response and work on separating these traumatic triggers from the conditioned response [2]. MDMA-assisted psychotherapy theoretically targets both the memory reconsolidation and fear extinction processes [3]. The term “memory reconsolidation” describes a type of neuroplasticity that involves the process of an established memory being reactivated, destabilized, and then modified or updated with additional information [4]. Hypothetically, when trauma memories are retrieved while under the influence of MDMA during therapy, a strong prediction error is generated by the unique internal state of MDMA-stimulated elevation of neurochemicals, hormones, and the supportive therapeutic setting [5]. This mismatch of experiences, such as recall of memory with strong fear/anxiety versus recall with emotions such as love or empathy, would allow for an update of the information through molecular mechanisms [https://www.drugabuse.gov/publications/research-reports/mdma-ecstasy-abuse/what-are-effects-mdma?utm_medium=email&utm_source=transaction ]. MDMA increases the release of dopamine (DA) in the striatum and midbrain. Dopamine positively correlates with prediction error, and therefore, MDMA-stimulated DA efflux may amplify and drive a prediction error related to the traumatic memory [6].

Clinicians have found that MDMA can be purified and used to facilitate the above-mentioned therapeutic effects [7]. MDMA promotes the release of dopamine, serotonin, and norepinephrine in the mesolimbocortical circuitry of the brain, as well as the neurohormonal signaling of oxytocin, cortisol, prolactin, and vasopressin [8]. The comprehensive effect of these neurochemicals has been shown to enhance therapeutic success as well as decrease nonresponse and dropout rates [9]. Long-lasting PTSD remission and a reduction in symptoms have been reported after only two to three MDMA-assisted therapy sessions [10].

The Meta Analysis dated 2014 to be removed. To replace with the information sourced from the meta analysis dated May 2021. the current data is redundant and contrary to more recent findings which clarifies all of the uncertainty and misinformation. Fredrickaltchwiezenbeurg (talk) 07:57, 25 September 2021 (UTC)

 Not done: Seems like a dubious journal, since it isn't included in MEDLINE ([11]) and has a very low impact factor (just above 1, which for medicine doesn't seem too convincing). Please see WP:MEDRS, this is unambiguously within the scope of that. RandomCanadian (talk / contribs) 12:23, 25 September 2021 (UTC)