MDMA Assisted Psychotherapy.
MDMA is a synthetic stimulant class drug that produces a high involving feelings of euphoria, connectedness and empathy, and energy. Although it has a reputation for being a club or raving drug, it has multiple therapeutic uses when used under medical supervision at safe dosages and in pure form as part of psychotherapy.
These include as a promising therapy for PTSD, social anxiety, alcohol use disorder, and possibly as a treatment alongside psychotherapy to treat depression. It is important to note that MDMA use alone without the psychotherapeutic component may cause more harm than good, as the drug is seen as key in facilitating psychotherapeutic work but when taken recreationally has not been shown to have these therapeutic effects so far.
MDMA can be deadly at high doses. And at smaller doses when combined with other drugs, especially PMA/PMMA which is often used to cut MDMA to intensify the high when getting it from a ‘recreational use’ source outside of a research medical setting. This is why drug kit testing is so important for harm reduction when it comes to recreational use.
At high doses, MDMA can cause serious and even life-threatening side effects ranging from agitation, hyperthermia, dehydration, seizure, and longer lasting (up to a week after use) ‘coming down’ effects such as depression and fatigue. Serotonin syndrome may also occur when combined with other drugs that affect serotonin receptors, including but not limited to prescription SSRIs and other antidepressants, and should not be used in combination.
There are some people who may be more susceptible based on epigenetic factors to the longer-lasting negative effects on memory due to a neurotoxic effect, especially at heavy recreational repeated use amounts, although the research is conflicted on the effects of lasting memory impairment and more research is needed to understand who may be at risk. Testing for genomic markers to risk stratify those who wish to use MDMA medicinally as part of MDMA psychotherapy may be helpful in the future.
MDMA is considered to have a low potential for addiction, especially when compared to alcohol, tobacco, or other stimulants like cocaine. However, a compelling desire to take it and difficulty controlling use has been reported in some recreational users. This risk appears to be very low in medical settings so far.