Date of Award

Spring 2021

Degree Name

Master of Medical Science (Physician Assistant)

Department

Physician Assistant; College of Health Sciences

First Advisor

Elizabeth Masten, MS, PA-C, Principal Faculty, Clinical Coordinator

Abstract

Introduction: MDMA, or 3,4-methylenedioxymethamphetamine, is a psychoactive chemical which stimulates the release of serotonin, oxytocin, prolactin, and cortisol. Up until it became a Schedule I drug in 1985, making the chemical completely illegal in the US, MDMA was used as an “adjunct to the therapeutic process” in therapeutic settings, though no known controlled therapeutic studies were performed up until that point. More recently, research has been conducted studying the effects of MDMA-Assisted Psychotherapy on helping to eliminate the fear responses common in patients afflicted with PTSD. Some researchers have further hypothesized that MDMA has a stronger, longer lasting effect on reducing these symptoms of PTSD than the traditional therapies used today. This document will be using the current available research to analyze how the efficacy of MDMA-Assisted Psychotherapy compares to the efficacy of traditional psychotherapy in treating anxiety symptoms in 18-40 year old patients diagnosed with PTSD.

Methods: The articles discussed in this paper were obtained via EBSCO research databases, google scholar, and google. Inclusion criteria involve the articles must discuss the effects of MDMA-assisted psychotherapy on PTSD, the effects of MDMA-assisted psychotherapy on anxiety, the pharmacodynamics of MDMA and how it can be used in treatment for mental illness, how MDMA-assisted psychotherapy compares to traditional psychotherapy, or any combination of the above parameters. All articles used for the research needed to be scholarly and peer-reviewed.

Results: The final research studies analyzed included five randomized control trials and one meta-analysis of randomized controlled studies. Three of these studies showed a significant difference in the reduction of CAPS scores between MDMA-AP and placebo-assisted psychotherapy (P < 0.05) and one study showed that this difference was not clinically significant (P > 0.05). The two remaining studies did not measure outcomes using CAPS scores but did show significant differences in the reduction of SSPTSD scores (P < 0.05) and LSAS scores (P < 0.05) for the group using MDMA-assisted psychotherapy compared to the group using placebo-assisted psychotherapy. Of these studies, only two had a patient population of >25 and three had a population size between 25 and 10.

Conclusion: A number of studies supporting MDMA-Assisted psychotherapy show promise as an alternative breakthrough therapy for patients with refractory anxiety symptoms of PTSD. However, change in the DEA’s drug scheduling and an increase in larger longitudinal studies with more diverse sample populations would be necessary before current practices can be changed and the therapy can be recommended for clinical use.

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Additional Files

Blake Beasley Capstone 2021.mp4 (14375 kB)
PICO Final Paper Edited.docx (96 kB)

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The Efficacy of MDMA-Assisted Psychotherapy Compared to the Efficacy of Traditional Psychotherapy in Treating Anxiety-Related Symptoms in 18–40-Year-Old Adults Diagnosed With Post-Traumatic Stress Disorder (PTSD)

Introduction: MDMA, or 3,4-methylenedioxymethamphetamine, is a psychoactive chemical which stimulates the release of serotonin, oxytocin, prolactin, and cortisol. Up until it became a Schedule I drug in 1985, making the chemical completely illegal in the US, MDMA was used as an “adjunct to the therapeutic process” in therapeutic settings, though no known controlled therapeutic studies were performed up until that point. More recently, research has been conducted studying the effects of MDMA-Assisted Psychotherapy on helping to eliminate the fear responses common in patients afflicted with PTSD. Some researchers have further hypothesized that MDMA has a stronger, longer lasting effect on reducing these symptoms of PTSD than the traditional therapies used today. This document will be using the current available research to analyze how the efficacy of MDMA-Assisted Psychotherapy compares to the efficacy of traditional psychotherapy in treating anxiety symptoms in 18-40 year old patients diagnosed with PTSD.

Methods: The articles discussed in this paper were obtained via EBSCO research databases, google scholar, and google. Inclusion criteria involve the articles must discuss the effects of MDMA-assisted psychotherapy on PTSD, the effects of MDMA-assisted psychotherapy on anxiety, the pharmacodynamics of MDMA and how it can be used in treatment for mental illness, how MDMA-assisted psychotherapy compares to traditional psychotherapy, or any combination of the above parameters. All articles used for the research needed to be scholarly and peer-reviewed.

Results: The final research studies analyzed included five randomized control trials and one meta-analysis of randomized controlled studies. Three of these studies showed a significant difference in the reduction of CAPS scores between MDMA-AP and placebo-assisted psychotherapy (P < 0.05) and one study showed that this difference was not clinically significant (P > 0.05). The two remaining studies did not measure outcomes using CAPS scores but did show significant differences in the reduction of SSPTSD scores (P < 0.05) and LSAS scores (P < 0.05) for the group using MDMA-assisted psychotherapy compared to the group using placebo-assisted psychotherapy. Of these studies, only two had a patient population of >25 and three had a population size between 25 and 10.

Conclusion: A number of studies supporting MDMA-Assisted psychotherapy show promise as an alternative breakthrough therapy for patients with refractory anxiety symptoms of PTSD. However, change in the DEA’s drug scheduling and an increase in larger longitudinal studies with more diverse sample populations would be necessary before current practices can be changed and the therapy can be recommended for clinical use.