MDMA could strengthen the bond between patient and therapist, thereby improving therapy as treatment for post-traumatic stress disorder

• New research suggests that MDMA (ecstasy) could improve trust and enhance the bond between patient and therapist, thereby enhancing treatment for PTSD.
• The team experimented with mice: They analyzed the effects of a low dose of MDMA versus saline solution and found that MDMA led to the mice being more sociable and for longer.
• The researchers went on to test the addiction potential of this low dosage of MDMA by giving mice the drug only when in a certain room of a two-room enclosure.
• They found that the mice did not display a preference for either room the next day, which suggests the low dose of MDMA did not trigger the reward center of the brain; however, a higher dose did exhibit abuse potential.
• After additional experimentation, the researchers showed that the release of serotonin causes the social effects of MDMA; these effects are not reliant on dopamine, which often contributes to drug abuse.
• The research team concludes that a low dose of MDMA given to a patient in the safe environment of a therapy office might improve trust and enable them to open up to their therapist; they are currently testing their theory in clinical trials.

Quick Summary

According to a new study “Distinct neural mechanisms for the prosocial and rewarding properties of MDMA,” published in Science Translational Medicine, MDMA (ecstasy) could improve trust between patient and therapist, thereby enhancing treatment for post-traumatic stress disorder. Researchers from Stanford University School of Medicine differentiated two molecular pathways, one responsible for addiction and the other for making people feel sociable when on MDMA.

Investigation and Findings

The research team experimented with mice, analyzing the effects of a low dose of MDMA versus saline solution. They looked specifically at their social decisions in a chamber that contained another mouse under a mesh cup, which kept the mouse from moving about, as well as a chamber that contained a mesh cup but with no mouse under it.

Next, researchers explored the addiction potential of MDMA. To do so, they gave mice a small dose of MDMA only when the mice were in a specific room of a two-room enclosure.

Findings

In their first round of experiments, researchers found, time and time again, that the mice on saline were bored after 10 minutes in the chamber with another mouse; however, the mice on MDMA attempted social interactions for at least 30 minutes. Additionally, when the researchers also gave the mouse under the mesh cup MDMA, this effect was even greater.

In the second round of experiments, the researchers found that the mice did not display a preference for either room the next day, which suggests that the low dose of MDMA did not trigger the reward center of the brain. Now, when the researchers gave the mice a higher MDMA dose, they exhibited abuse-potential in addition to the social activity seen previously.

With additional experimentation, the researchers showed that the release of serotonin (triggered by the low dosage, equivalent to what they gave the mice) causes the social effects of MDMA—these effects are not reliant on the release of dopamine, which often contributes to drug abuse.

Implications

MDMA (Methylenedioxy-methamphetamine), or ecstasy, is a mind-altering drug that causes people to be exceptionally sociable and outgoing. For this very reason, MDMA is a popular party drug. But, it might prove beneficial to psychotherapy for the same reason. Researchers are now testing MDMA as a supplement to therapy for individuals with post-traumatic stress disorder.

The research team says that low doses of MDMA might improve the bond between patient and therapist, in just one session. In the case of trauma victims, the patient could feel more comfortable opening up about their experience. The level of trust that might result from one single dose of MDMA in the safe environment of a therapy office could equal that of a patient and therapist who have been working together for months or even years.

Researchers acknowledge that MDMA can be addictive. However, the low dose that would be administered to a patient in therapy would not activate the molecular pathway responsible for addiction. Instead, the molecular pathway responsible for increased sociability will activate and the patient will solely experience the social effects from the release of serotonin.

Limitations

• This research used mice as their test subjects; that said, the same effects are likely to be seen in humans due to the brain areas in question.

Source:

Heifets, B. D., Salgado, J. S., et al (2019, December 11). Distinct neural mechanisms for the prosocial and rewarding properties of MDMA. Science Translational Medicine. Retrieved from https://stm.sciencemag.org/content/11/522/eaaw6435

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