Time to Rethink MDMA’s Potential to Treat PTSD?

On the heels of the U.S. Food and Drug Administration’s decision to greenlight cannabis research to treat post-traumatic stress disorder (PTSD), new research reveals MDMA could help, too.

UCLA Health’s Walter Dunn, MD, published his review of the existing literature in NeuroRehabilitation, which suggests that MDMA could boost the therapeutic relationship and accelerate the recovery process.

A Long Road to Recovery

Service members (and veterans) who survive neurological injuries sustained during training or live combat, typically face emotional and cognitive challenges. These struggles can make  recovery that much more challenging, even without an official PTSD diagnosis.

Dunn, an assistant clinical professor of psychiatry and a U.S. Marine Corps veteran, points out that making the switch from the structure of military life to the uncertainty of a medical discharge in a civilian setting frequently sparks feelings of isolation, self-doubt, and emotional turmoil — all of which can hamper neurorehabilitation.

Multiple clinical trials have backed up the theory that MDMA-assisted therapy could help treat PTSD. A sample of trials results show that – among other things – it curbs treatment dropout rates and improves therapy tolerance. Dunn attributes that to the drug’s ability to foster social connections, nurture self-esteem, and strengthen neural plasticity.

“These are highly fit individuals who experience a life-altering injury that can upend their future,” Dunn explained. “MDMA-assisted therapy could offer them a vital tool for rebuilding trust and emotional resilience.”

The analysis covers doses that range from 75 mg to 125 mg, which he says amplify feelings of social reward while encouraging stronger bonds between patients and therapists. This reinforced therapeutic alliance could play a crucial part of neurorehabilitation. But, his review points out that no published research has tested MDMA’s impact in this context.

Dunn’s review also highlights the drug’s potential to offset issues of low self-esteem, which can make things worse for survivors struggling with emotional dysfunction.

Moving Forward

Dunn concludes with a call for more data on MDMA’s influence on neuroplasticity, an important mechanism in the brain’s ability to adapt and recover from trauma. Earlier research involving mice suggest that MDMA curbs anxiety behaviors, boosts memory function, and amplifies  social learning. But he adds that more research – involving humans could validate (or debunk) these results.

Earlier this year, the FDA rejected a bid to allow the use of MDA in PTSD treatment. In justifying its denial, regulators, in part, cited the drug’s classification as a Schedule I narcotic. This designation describes MDMA as having “no currently accepted medical use” along with its elevated abuse potential.

Dunn, who served on the FDA advisory board that evaluated the application, served as the only dissenting vote, citing both its efficacy and safety.

“Military service inherently involves exposure to stress and danger,” Dunn said. “This reality underscores the urgent need to develop innovative treatments to support those who serve and sacrifice for their country.”

While MDMA-assisted therapy continues to show promise, Dunn – and advocates like him – argue how important it is to keep exploring the full therapeutic potential of MDMA for veterans battling PTSD.

Further Reading

Why FDA Panel Rejected MDMA for PTSD Treatment

Women Veterans Face 67% Higher Risk of Inappropriate PTSD Prescriptions

Understanding Gender Differences in PTSD