Even as someone who has used this recreational, I'm very sceptical about mdma for medical treatment.
I have seen smart people needing professional help for a very long time after using this too often. And too often is already every second weekend, because the body needs so long to restore the serotonine.
But maybe they are using very little doses? I can still not believe that taking this regularily is a good idea.
Edit: Sry for not reading it carefully enough to find the dosage.
Still 120-180 mg with only one month in between is a lot.
If only there were some mechanism by which we could separate people's personal vibes and anecdata from actual scientific understanding... perhaps a series of clinical trials?
History will look unkindly upon people who kept these substances out of the hands of people who need them because "I knew a guy once who did too much street MDMA and went stupid."
Honestly, adopting that position in the face of a well-designed Phase 3 RCT showing such strong results is pretty much actively evil as far as I'm concerned. People are suffering. People are blowing their brains out after combat; people are afraid to get in their cars after accidents, or walk outside or have sex after being raped, and you're like "ehh Idk I knew a guy." Come on.
Its not like "I know a guy". Its like common knowledge for people who do this stuff that it seriously fucks you up if you do this too often. Its like 100% guaranteed.
I would not take this every day for a month even if you offer me a years salary.
Every medic who thinks this is a good idea should do the self test in my opinion.
The same goes for giving ritalin to kids, but that is a different story...
Why don't you just say folk wisdom? Commonly rumored? Calling something "knowledge" doesn't make it such. The entire point of science, and the reason it's so ridiculously hard, is that common knowledge is so frequently wrong.
> I would not take this every day for a month even if you offer me a years salary.
Then don't? No one is asking you to, nor is this trial nor the proposed line of treatment anything like this.
> Every medic who thinks this is a good idea should do the self test in my opinion.
I have a better proposal: how about they do a bunch of solid RCTs on it? That way we get actual information instead of noise.
I'm also I since guy, so I'm not against what you are saying. Your just twisting my words.
You know the story of mdma? It was developed for medical use...
And I sayd im skeptical of this, because I cannot imagin, that any serious study, considering the risks comes to this conclusion. Unless it literally stops people from suicid. But as far as I know it's more probable to increase this risk so idk.
But dude, that's the whole point of these studies! It's really hard to know what a given drug does! We should absolutely factor in people's subjective experiences and recreational experiments in terms of deciding whether it's worth investigating something more thoroughly, but once real, high-quality studies are done (especially RCTs), people's recreational experiences hold very little water when they are in conflict with the study.
Yes I also misunderstood the usage. They make a therapy session once a month where the patient gets high before the session.
On the other hand, they dont factor in the body mass of the patient and give everyone the same dosage. That doesnt seem high quality to me. And 120-180mg isn't just a little. Thats at the upper end of what you would take when you go to a party, just for reference. Give this to someone with 60kg body mass and they can have a very bad experience.
The dosages are discovered and defined by the Phase I trial, also in a very systematic way that is meant to break free of folk wisdom about correct dosages.
Taking multiple "points" (100mg doses) in a single session is extremely common among enjoyers of MDMA.
People don't really build tolerance to MDMA when they use it responsibly.
This is a phase 3 clinical trial, aka the last and most rigorous phase before potential FDA approval. There have already been studies previous to this one that establish safe bounds for dosage of chemically pure MDMA in a clinical setting, many of which are targeted at patients with "no tolerance" (aka drug naïve).
You are clutching pearls pretty hard here. Experimental medicine is not without risks. Apparently 8 whole active study group participants (less than 10%) experienced mild tachycardia, aka fast heartbeat, in a setting full of trained medical professionals with the skills and equipment to handle such events. There was also some sweating and nervousness. Compare that to a moderate to bad episode of PTSD and it's a walk in the park by comparison. This is highly ethical research. Take a breath and carefully read the full study and some of its references, as well as some other ones prior to this phase 3 trial, if you are seriously concerned about this issue.
> Taking multiple "points" (100mg doses) in a single session is extremely common among enjoyers of MDMA.
300mg, especially for someone without prior MDMA experience, is an absolutely unhinged hero dose.
300mg spaced out over the course of 12 hours or so is somewhat less so, but you absolutely will get fewer effects on re-dosing, and fewer the next day as well if you dose again.
That said 120mg should be pretty safe for anyone, but with lower-tolerance or lighter users, could definitely reduce their ability to engage in meaningful conversation or retain any memory of what they discussed.
Which isn't to say they won't come away from the experience feeling warm fuzzies and possibly with significant improvements in their PTSD symptoms, but it does make me wonder if it's a good way to study how much of that is the talk therapy and how much is just the therapeutic effects of the drug
MDMA-AT is definitely not taking it regularly. It is done only a handful of times, with pharmaceutical-grade MDMA and no other adulterants, in controlled doses, in a controlled setting. Very different than a Tesla pill at a rave every other weekend.
Ok, not regularly already makes more sense. Still the dosage would be very interesting, and the time interval. I didn't talk about tesla pills, but mdma crystals dosed with a high precision weight according to body mass.
That a tesla pill with 0-300 mg can be harmful is obvious^^
The proposed use is MDMA-assisted therapy. Take a dose, talk to a therapist. Wait a month, repeat. You seem to be imagining people popping the stuff like SSRIs.
Intuitively, this makes a lot of sense. MDMA is a fun drug because of the fact that it makes it basically impossible to feel negative emotion under its effect. PTSD is characterized by extreme negative emotion around a particular trauma, to such an extent that it becomes disruptive to living a normal life. Just talking about the traumatic inducing experience can lead to uncontrolled emotional responses, making it difficult to approach therapeutically. The MDMA acts as a shortcut around that last bit: by blocking the patient from feeling negative emotion while they talk about their trauma, they can re-evaluate it in a more removed way.
Combine that with theories about how we edit memories when we recall them, and you've got a pretty obvious method of action.
It's not intended to be a chronically taken treatment. But the results were pretty massive. That CAPS-5 score they talk about the reduction by 24 points versus therapy alone's 15 is on an 80 point scale, with the bare minimum for PTSD diagnosis at a 12, and "moderate" PTSD being in the 23-35 range.
Compared to most results coming out of the mental illness treatment field, MDMA's looking like a silver bullet.
As other commenters have noted, this is MDMA-assisted therapy. Controlled dose, setting, with supportive professionals.
But one interesting thing to note:
> Least squares (LS) mean change in CAPS-5 score (95% confidence interval (CI)) was −23.7 (−26.94, −20.44) for MDMA-AT versus −14.8 (−18.28, −11.28) for placebo with therapy (P < 0.001, d = 0.7).
The placebo group got better, too! What this means is that therapy for PTSD actually works! It just works better on average with MDMA assistance.
> And too often is already every second weekend, because the body
The intended therapy is taken several times in a guided sessions, 3 for this study, with a therapist. They aren't just sending people home with a bottle of mdma to take before bed.
Yeah my impression of a therapeutic setting would be an asymptotic progression of a few doses in short intervals with an exponential back-off ending in no further uses or perhaps once a year.
Resets are not a recurring situation. I'd take it as a sign of using the treatment in bad faith.
nobody knows the correct dose because nobody could do the trial
it could be anything in any interval or nothing
we have FDA approved treatments that say “don’t do this for more than 2 years” and at the very least we can make objective choices because the side effects are listed… because those also occurred
to an actual human being in a controlled environment
I have seen smart people needing professional help for a very long time after using this too often. And too often is already every second weekend, because the body needs so long to restore the serotonine.
But maybe they are using very little doses? I can still not believe that taking this regularily is a good idea.
Edit: Sry for not reading it carefully enough to find the dosage.
Still 120-180 mg with only one month in between is a lot.