Abstract
This paper provides a brief review of the history, proposed pharmacological mechanisms, safety issues, and clinical applications of the medicine 3,4-methylenedioxymethamphetamine (MDMA). Most clinical MDMA research in patients to date has focused on MDMA-assisted psychotherapy to treat posttraumatic stress disorder (PTSD). In this review paper other potential therapeutic applications for MDMA therapy are described, including contemporary studies treating anxiety associated with autism and the authors' ongoing study exploring the potential role for MDMA-assisted psychotherapy to treat alcohol use disorder. MDMA therapy for PTSD is now entering the final Phase 3 stage of drug development, with a target set for licensing by the FDA and EMA in 2021. This means that if clinical efficacy criteria are achieved, MDMA would become a medicine.
Highlights
we are seeing a broadening of the clinical possibilities for the compound
increasingly recognizing the role played by early psychological trauma in a range
erroneous media-driven opinion must not be allowed to dictate the progress of medical research
Summary
In the late 1960’s, after lysergic acid diethylamide (LSD) was banned, some psychedelic therapists began exploring other drugs as tools to enhance psychotherapy. The clinical MDMA research community requested a hearing to debate the DEA’s intention, but in May 1985 MDMA was initially placed in an emergency Schedule One category and subsequently became permanently scheduled thereafter, where it has stayed ever since—hugely restricting opportunities for its research [6] Due to this Catch 22 situation, very little clinical research was able to take place. In the mid-eighties, a series of uncontrolled case studies, conducted before the ban, were published These described the effective use of MDMA with individuals, couples and groups [7, 8]. Throughout the 1990s, tensions developed between the clinical MDMA community, who proposed MDMA was safe in controlled circumstances, and the media and politicians who favored strict prohibition to control recreational use During this decade the UK brewing industry sponsored widely publicized anti-Ecstasy campaigns in response to their business being eroded by Ecstasy use [11]. After just 1 year, a political backlash by the Spanish government shut down the study
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