Ecstasy may help suffers of post-traumatic stress learn to deal
with their memories more effectively by encouraging a feeling of
safety, according to an article in the Journal of
Psychopharmacology published by SAGE.
Studies have shown that a type of psychological treatment called
exposure therapy - where the patient repeatedly recalls the traumatic
experience or is repeatedly exposed to situations that are safe but
still trigger their traumatic feelings - can be effective in relieving
stress responses in patients with post-traumatic stress disorder (PTSD)
and other anxious conditions. The therapy works by helping the patient
to re-learn the appropriate response to the trigger situation, a
process known as extinction learning.
But this approach can take some time, and 40% of patients continue
to experience post-traumatic stress even after their treatment. To
improve outcomes, scientists have been investigating the use of drug
therapies to enhance the effect of exposure therapy, making the result
of exposure to the fear trigger easier, faster, and more effective.
MDMA (the pharmaceutical version of Ecstasy) is one such drug.
"A goal during exposure therapy for PTSD is to recall distressing
experiences while at the same time remaining grounded in the present.
Emotional avoidance is the most common obstacle in exposure therapy for
PTSD, and high within-session emotional engagement predicts better
outcome," explain authors Pål-Ørjan Johansen and Teri
Krebs, who are based at the Norwegian University of Science and
Technology and supported by the Research Council of Norway.
Psychiatrists that have administered MDMA to anxiety patients have
noted that it promotes emotional engagement; strengthens the bond
between the patient and doctor, known as the therapeutic alliance;
decreases emotional avoidance; and improves tolerance for recall and
processing of painful memories.
According to Johansen and Krebs, "MDMA [ecstasy] has a combination
of pharmacological effects that…could provide a balance of activating
emotions while feeling safe and in control."
They suggest three possible biological reasons why ecstasy could
help individuals with PSTD. First, ecstasy is known to increase the
release of the hormone oxytocin, which is involved in trust, empathy,
and social closeness.
Because people with PTSD often report feeling emotionally
disconnected and unable to benefit from the supportive presence of
family and friends or therapists - a situation that is likely to
contribute to the development and maintenance of the disorder - use of
ecstasy might also help ameliorate these symptoms, suggest the authors.
"By increasing oxytocin levels, MDMA may strengthen engagement in
the therapeutic alliance and facilitate beneficial exposure to
interpersonal closeness and mutual trust," they write.