The Science of MDMA & Its Therapeutic Uses: Benefits & Risks

In this episode, I discuss methyl​enedioxy​methamphetamine (MDMA), which is also commonly known as “ecstasy” or “molly,” including how it works in the brain to cause short- and long- term-shifts in emotional processing and its clinical applications for the treatment of post-traumatic stress disorder (PTSD), alcohol and other substance-use addictions. I discuss the neuronal mechanisms for how MDMA elevates mood, empathy, motivation, social engagement, and reduces “threat detection” and how these effects can synergistically support talk therapy. I also explain the ongoing debate about the potential neurotoxicity of MDMA, myths about the origins and treatments for post-MDMA “crash,” the evolving legal landscape around MDMA use for clinical purposes, and I caution recreational users about the extremely dangerous additives (e.g., fentanyl) now commonly found in black market MDMA. This should be of interest to those curious about MDMA, neuropharmacology, the origins of emotional processing in the brain, empathy, PTSD, neuroplasticity, mental health and psychiatry.

Articles

• A Conserved Role for Serotonergic Neurotransmission in Mediating Social Behavior in Octopus30991-6?returnURL=https://linkinghub.elsevier.com/retrieve/pii/S0960982218309916%3Fshowall%3Dtrue) (Current Biology_)
• Effects of MDMA on sociability and neural response to social threat and social reward (Psychopharmacology)
• The Effects of Acutely Administered 3,4-Methylenedioxymethamphetamine on Spontaneous Brain Function in Healthy Volunteers Measured with Arterial Spin Labeling and Blood Oxygen Level–Dependent Resting State Functional Connectivity00005-5/fulltext) (Biological Psychiatry)
• Distinct neural mechanisms for the prosocial and rewarding properties of MDMA (Science Translational Medicine)
• Plasma oxytocin concentrations following MDMA or intranasal oxytocin in humans (Psychoneuroendocrinology)
• RETRACTED: Severe Dopaminergic Neurotoxicity in Primates After a Common Recreational Dose Regimen of MDMA (“Ecstasy”) (Science)
• Science forced to retract article on “ecstasy” (BMJ)
• Residual neurocognitive features of long-term ecstasy users with minimal exposure to other drugs (Addiction)
• MDMA-assisted therapy for severe PTSD: a randomized, double-blind, placebo-controlled phase 3 study (Nature Medicine)
• The effects of MDMA-assisted therapy on alcohol and substance use in a phase 3 trial for treatment of severe PTSD (Drug & Alcohol Dependence)

Books

• PIHKAL: A Chemical Love Story (by Alexander Shulgin and Ann Shulgin)
• Trauma: The Invisible Epidemic (by Paul Conti M.D.)
• The Body Keeps the Score (by Bessel van der Kolk M.D.)

Other Resources

• Multidisciplinary Association for Psychedelic Studies (MAPS)
• Participate in a MAPS trial
• How Psilocybin Can Rewire Our Brain, Its Therapeutic Benefits & Its Risks
• Dr. Robin Carhart-Harris: The Science of Psychedelics for Mental Health
• Controlling Your Dopamine For Motivation, Focus & Satisfaction
• Leverage Dopamine to Overcome Procrastination & Optimize Effort