MDMA-assisted psychotherapy for treatment of anxiety and other psychological distress related to life-threatening illnesses: a randomized pilot study

Wolfson, Philip E.; Andries, Julane; Feduccia, Allison A.; Jerome, Lisa; Wang, Julie B.; Williams, Emily; Carlin, Shannon; Sola, Evan; Hamilton, Scott; Yazar‐Klosinski, Berra; Emerson, Amy; Mithoefer, Michael C.; Doblin, Rick

doi:10.1038/s41598-020-75706-1

Cited by 102 publications

(144 citation statements)

References 52 publications

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“…While we did not directly measure depressive symptoms and anxiety, our findings regarding empathogens use contradict the common notion of MDMA induced mood disorders. What is more, MDMA assisted psychotherapy was recently found to decrease anxiety and distress in patients with life-threatening diseases (Wolfson et al, 2020), and social anxiety in patients with autism (Danforth et al, 2018). While these findings are preliminary, together with our result they point out that psychological problems commonly associated with MDMA use should be carefully revisited.…”

Section: Relation Of Emotional Reactivity and Self-consciousness With Other Substances And With Meditation Practicesupporting

confidence: 57%

Psychedelics use predicts more positive emotional reactivity and diminished outward-focused self-consciousness: the mediating role of ego dissolution and mystical experiences

Orłowski¹,

Ruban²,

Szczypiński³

et al. 2021

Preprint

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Background: Psychedelics are able to acutely alter emotional reactivity and self-consciousness. However, whether regular, naturalistic use of psychedelics can be linked to more persistent, trait-level changes in these domains remains an open question.Aim: To test three hypotheses: i) psychedelics use is related to higher positive and lower negative emotional reactivity; ii) psychedelics use is related to enhanced inward-focused self-consciousness and diminished outward-focused self-consciousness; iii) these relations are mediated by the intensity of past ego-dissolution and mystical experiences.Methods: Data from 2,516 participants (1,661 psychedelics users) were collected via an online survey. The survey included questions about the history of psychoactive substance use, questionnaires measuring trait-levels of emotional reactivity and self-consciousness, and questionnaires for retrospective assessment of ego-dissolution and mystical experiences. Data were analyzed using robust linear regression and mediation analysis.Results: First, a higher number of lifetime psychedelic experiences predicted greater positive and lower negative emotional reactivity. Second, in the domain of self, it predicted greater reflection and internal self-awareness, and reduced rumination tendency and public self-consciousness. Finally, intensity of past mystical and ego-dissolution experiences mediated almost all observed relationships between the lifetime psychedelics use and psychological variables. Conclusions: Lifetime psychedelics use predicts an adaptive pattern of trait-level emotional reactivity and self-consciousness. The past ego-dissolution and mystical experiences are essential in understanding the long-lasting psychological effects of psychedelics use. Our findings might potentially explain previous observations of increased well-being in psychedelics users.

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Section: Relation Of Emotional Reactivity and Self-consciousness With Other Substances And With Meditation Practicesupporting

confidence: 57%

Psychedelics use predicts more positive emotional reactivity and diminished outward-focused self-consciousness: the mediating role of ego dissolution and mystical experiences

Orłowski¹,

Ruban²,

Szczypiński³

et al. 2021

Preprint

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“…In most studies, psychedelic administration led to a reduction in depressive symptoms [ 33 , 34 , 35 , 36 , 42 , 43 , 44 ]. Among the randomized controlled trials, all four studies with psilocybin, three with MDMA, and one with DMT demonstrated significant efficacy in reducing the symptoms of depression and in reducing amygdala hyperactivity, a distinctive feature of depression.…”

Section: Discussionmentioning

confidence: 99%

“…The changes were similar in both groups but more strongly expressed in the MDMA group. The MDMA treatment was well tolerated, and no serious adverse events were reported [ 35 ].…”

Section: Reviewmentioning

confidence: 99%

“…In the psilocybin studies, there were also gastroenterological adverse events noted, most commonly nausea and/or vomiting [ 30 , 31 , 32 , 41 , 42 ]. Most researchers measured blood pressure and heart rate during psilocybin studies and observed an elevation in blood pressure [ 30 , 31 ] and heart rate [ 30 ]; however, these increases were often not considered adverse events [ 32 , 33 , 34 , 35 , 36 , 41 , 42 ]. There were also some general adverse events noted, mostly in MDMA studies, including fatigue [ 32 , 33 , 34 ] and a lack of appetite [ 33 , 34 , 35 ].…”

Section: Reviewmentioning

confidence: 99%

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The Potential Role of Serotonergic Hallucinogens in Depression Treatment

Psiuk

Nowak

Cholewa

et al. 2021

Life

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Due to an increasing number of depression diagnoses and limited effective treatments, researchers continue to explore novel therapeutic strategies for this disorder. Recently, interest has revolved around the use of serotonergic psychedelics to reduce the symptoms of depression. In this systematic review, we summarize the currently available knowledge on the safety and efficacy of psychedelic substances for the treatment of depression. A literature search of the PubMed/MEDLINE database identified 14 clinical trials from the last 10 years that examined the use of psilocybin, MDMA, DMT, or LSD for the treatment of depression symptoms. Some psychedelics, especially psilocybin, demonstrated an ability to reduce depressive symptoms as measured by several psychological scales, which was often sustained for months after the last psychedelic session. Moreover, one study revealed that psilocybin has comparable efficacy to escitalopram in the treatment of depression. None of the studies reported any serious adverse events associated with psychedelic administration. The reviewed studies suggest that psychedelics have great potential in depression therapy and, after addressing and overcoming the current study limitations, may be used as a novel method of treating depression in the future.

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“…While two SSRIs have been approved for PTSD, pooled data indicate that MDMA-assisted psychotherapy may constitute "a substantial improvement over available pharmacotherapies in terms of safety and efficacy" (54). Other research suggests MDMA-assisted psychotherapy may be efficacious for treating social anxiety among adults with autism, end-of-life anxiety/psychological distress, alcohol use disorder and eating disorders (55)(56)(57)(58). Based on these findings, researchers recommend that MDMA-assisted psychotherapy be expeditiously evaluated for clinical use (50).…”

Section: Mdma-assisted Psychotherapy For Trauma-related Disordersmentioning

confidence: 99%

Psychedelic-Assisted Psychotherapy After COVID-19: The Therapeutic Uses of Psilocybin and MDMA for Pandemic-Related Mental Health Problems

et al. 2021

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The COVID-19 pandemic stands to have impacts on mental health and well-being that will extend beyond its formal resolution. Before COVID-19, mental health disorders were already challenging global healthcare systems, directly accounting for 7.4% of the total burden of disease (1, 2). An estimated 1 billion people worldwide suffer from a mental health disorder, with the two most common disorders-depression and anxiety-costing the global economy US$1 trillion per year (3). Stigma and limited treatment options have amounted to substantial unmet need and violations in human rights for people with mental health disorders (1,4,5). Looking ahead, heightened postpandemic demand for mental healthcare signifies an urgent need to bolster clinical capacity by integrating novel, cost-effective approaches into existing systems (6).Emergent literature globally describes the diverse impacts of COVID-19 on mental health (7, 8). For instance, available data among hospitalized COVID-19 patients in China revealed that approximately 96% suffered post-traumatic stress symptoms (9). Studies among intensive care unit (ICU) patients with previous coronaviruses infer high rates of posttraumatic stress disorder (PTSD), depression and anxiety (30-40%) persisting months after discharge (10), with similar rates observed in patients infected with . Highly exposed individuals such as frontline healthcare workers are susceptible to similarly negative outcomes due to prolonged occupational stress, elevating risk of PTSD and suicidality (12-14). Importantly, post-pandemic mental disorders are not limited to individuals directly exposed to COVID-19. Rather, research documents PTSD symptoms among individuals who have been indirectly exposed by witnessing (e.g., via the media) or being confronted with the threat of death or serious illness (e.g., worry/anticipation about the future) (7).COVID-19 has significantly altered lives in ways that exacerbate drivers of mental health problems, with widespread uncertainty, increased experiences of grief and loss, social isolation, economic and housing instability, and decreased access to critical services related to lockdowns (6,15). Further, available data on the impacts of COVID-19 on substance use patterns indicate increased use of alcohol and other substances in response to stress and negative emotions (8,16,17). Social connections are crucial for people struggling with addiction and comorbidities such as depression, and increased social disconnection represents a key risk factor for adverse outcomes Publisher's Note: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

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MDMA-assisted psychotherapy for treatment of anxiety and other psychological distress related to life-threatening illnesses: a randomized pilot study

Cited by 102 publications

References 52 publications

Psychedelics use predicts more positive emotional reactivity and diminished outward-focused self-consciousness: the mediating role of ego dissolution and mystical experiences

Psychedelics use predicts more positive emotional reactivity and diminished outward-focused self-consciousness: the mediating role of ego dissolution and mystical experiences

The Potential Role of Serotonergic Hallucinogens in Depression Treatment

Psychedelic-Assisted Psychotherapy After COVID-19: The Therapeutic Uses of Psilocybin and MDMA for Pandemic-Related Mental Health Problems

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