MDMA does not alter responses to the Trier Social Stress Test in humans

Abstract

Rationale ±3,4-Methylenedioxymethamphetamine (MDMA, “ecstasy”) is a stimulant-psychedelic drug with unique social effects. It may dampen reactivity to negative social stimuli such as social threat and rejection. Perhaps because of these effects, MDMA has shown promise as a treatment for post-traumatic stress disorder (PTSD). However, the effect of single doses of MDMA on responses to an acute psychosocial stressor has not been tested. Objectives In this study, we sought to test the effects of MDMA on responses to stress in healthy adults using a public speaking task. We hypothesized that the drug would reduce responses to the stressful task. Methods Volunteers (N = 39) were randomly assigned to receive placebo (N = 13), 0.5 mg/kg MDMA (N = 13), or 1.0 mg/kg MDMA (N = 13) during a stress and a no-stress session. Dependent measures included subjective reports of drug effects and emotional responses to the task, as well as salivary cortisol, heart rate, and blood pressure. Results The stress task produced its expected increase in physiological responses (cortisol, heart rate) and subjective ratings of stress in all three groups, and MDMA produced its expected subjective and physiological effects. MDMA alone increased ratings of subjective stress, heart rate, and saliva cortisol concentrations, but contrary to our hypothesis, it did not moderate responses to the Trier Social Stress Test. Conclusions Despite its efficacy in PTSD and anxiety, MDMA did not reduce either the subjective or objective responses to stress in this controlled study. The conditions under which MDMA relieves responses to negative events or memories remain to be determined.

Modulation of Social Cognition via Hallucinogens and “Entactogens”

“…Social exclusion often leads to social stress (74). Yet, MDMA (0.5 and 1.0 mg/kg) did not alter the response to social stress in the Trier Social Stress Test (75).…”

Psychoactive Drugs in the Management of Post Traumatic Stress Disorder: A Promising New Horizon

“…In addition, it increases the release of other monoamine neurotransmitters such as dopamine and noradrenaline [ 38 ]. MDMA appears to impact users by decreasing their reactivity to negative stimuli such as threats while enhancing feelings of empathy, openness, and euphoria [ 39 ] through the release of both dopamine and noradrenaline. These effects seemingly target and address many of the fears of negative stimuli faced by PTSD patients.…”

“…Several studies have aimed to study the efficacy of MDMA-assisted psychotherapy in these populations. A randomized, double-blind, dose-response clinical trial for military veterans or first responders with diagnosed chronic PTSD according to the Clinician-Administered PTSD Scale (CAPS-IV), showed that increased doses of MDMA in conjunction with psychotherapy decreased PTSD symptom severity one month after treatment [ 39 , 43 ]. PTSD short-term symptom severity was also significantly decreased in participants that were treated with an initial low dose and a subsequent higher dose one month later, suggesting that high-dose administration of MDMA is effective at relieving PTSD symptoms [ 43 ].…”

Activación emocional en sujetos humanos: procedimientos para la inducción experimental de estrés

“…The Trier Social Stress Test (TSST) is a widely validated protocol for the induction of psychosocial stress under laboratory conditions (McRae et al, 2006;Villada, Hidalgo, Almela, & Salvador, 2016;Bershad, Miller, & De Wit, 2017). The TSST includes a period of preparation of an oral presentation, a period for the execution of the presentation and one for performance in an arithmetic mental challenge (successive subtractions with intermediate level of difficulty).…”