Two papers on MDMA psychotherapy

Two papers on MDMA psychotherapy

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=17329304&query_hl=8&itool=pubmed_docsum

J Psychopharmacol. 2007 Mar;21(2):220-4.
Is there a case for MDMA-assisted psychotherapy in the UK?
Sessa B. Psychopharmacology Unit, Dorothy Hodgkin Building, Bristol, UK.
ABSTRACT
Much has been written in scientific and popular literature in recent years about the dangers surrounding the recreational use of the drug MDMA/ecstasy.
What is little known and understood however is the history of the apparently safe and effective use of MDMA as a therapeutic tool for psychotherapy.
In this paper the author explores this history and describes the recent re-emergence of scientific interest in MDMA and other psychedelic drugs.
There are currently several new double-blind randomised controlled trials underway re-visiting the subject.
By acknowledging the limitations of this new research and emphasising the importance of exercising appropriate but realistic caution, the author asks that the medical profession consider a dispassionate and open-minded debate to examine whether MDMA might have a legitimate place as an adjunct to psychotherapy in modern psychiatric practice.

----

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=17297639&query_hl=8&itool=pubmed_docsum

Psychopharmacology (Berl). 2007 Apr;191(2):181-93. Epub 2007 Feb 13
The psychotherapeutic potential of MDMA (3,4-methylenedioxymethamphetamine): an evidence-based review.
Parrott AC. Department of Psychology, University of Wales Swansea, Swansea, SA2 8PP, Wales, UK, a.c.parrott@swansea.ac.uk.
ABSTRACT
AIMS AND RATIONALE: The purpose of this study was to review whether methylenedioxy-methamphetamine (MDMA) has the appropriate pharmacodynamic profile to be a therapeutic agent.
MATERIALS AND METHODS: Empirical descriptions of MDMA's subjective effects in humans will be reviewed to evaluate the proposal that MDMA has psychotherapeutic properties. The focus will be published evidence on its functional effects in therapeutic, medical, and other situations.
RESULTS: MDMA is a powerful central nervous system (CNS) stimulant which affects several neurotransmitter systems and intensifies a range of psychobiological functions. Its acute mood effects can be very positive and life enhancing, and the affirmative cognitions engendered during MDMA therapy may well endure afterwards.
However, MDMA also has a number of potential anti-therapeutic characteristics. Acutely, it can also intensify negative cognitions, and these may similarly endure over time. Psychotherapists have found that setting, intention, and expectancy are crucial for a positive outcome, but these factors cannot be guaranteed. Post-MDMA, there is a period of neurotransmitter recovery when low moods predominate, and these may exacerbate psychiatric distress.
The explanations proposed for MDMA-assisted therapy are all psychodynamic, and a neurochemical model needs to be outlined. It has been suggested that enduring therapeutic gains can follow a single session, but again, this lacks a clear psychopharmacological rationale.
Finally, diathesis-stress models suggest that psychiatric individuals are more prone to acute and chronic abreactions to CNS stimulants such as MDMA.
CONCLUSIONS: There are a number of issues which need to be addressed before it can be argued that MDMA might be clinically useful for psychotherapy.Parrott AC.
Department of Psychology, University of Wales Swansea, Swansea, SA2 8PP, Wales,
UK, a.c.parrott@swansea.ac.uk.



ABSTRACT

AIMS AND RATIONALE: The purpose of this study was to review whether methylenedioxy-methamphetamine (MDMA) has the appropriate pharmacodynamic profile to be a therapeutic agent.

MATERIALS AND METHODS: Empirical descriptions of MDMA's subjective effects in humans will be reviewed to evaluate the proposal that MDMA has psychotherapeutic properties. The focus will be published evidence on its functional effects in therapeutic, medical, and other situations.

RESULTS: MDMA is a powerful central nervous system (CNS) stimulant which affects several neurotransmitter systems and intensifies a range of psychobiological functions. Its acute mood effects can be very positive and life enhancing, and the affirmative cognitions engendered during MDMA therapy may well endure afterwards.

However, MDMA also has a number of potential anti-therapeutic characteristics. Acutely, it can also intensify negative cognitions, and these may similarly endure over time. Psychotherapists have found that setting, intention, and expectancy are crucial for a positive outcome, but these factors cannot be guaranteed. Post-MDMA, there is a period of neurotransmitter recovery when low moods predominate, and these may exacerbate psychiatric distress.

The explanations proposed for MDMA-assisted therapy are all psychodynamic, and a neurochemical model needs to be outlined. It has been suggested that enduring therapeutic gains can follow a single session, but again, this lacks a clear psychopharmacological rationale.

Finally, diathesis-stress models suggest that psychiatric individuals are more prone to acute and chronic abreactions to CNS stimulants such as MDMA.

CONCLUSIONS: There are a number of issues which need to be addressed before it can be argued that MDMA might be clinically useful for psychotherapy.