How could MDMA (ecstasy) help anxiety disorders? A neurobiological rationale

P.-Ø. JOHANSEN · Teri Suzanne Krebs

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Psychedelics and Drug Studies Psychotherapy Techniques and Applications Treatment of Major Depression

Abstract

Exposure therapy is known to be an effective treatment for anxiety disorders. Nevertheless, exposure is not used as much as it should be, and instead patients are often given supportive medications such as serotonin reuptake inhibitors (SSRIs) and benzodiazepines, which may even interfere with the extinction learning that is the aim of treatment. Given that randomized controlled trials are now investigating a few doses of +/-3,4-methylenedioxymethamphetamine (MDMA, 'ecstasy') in combination with psychotherapy for treatment-resistant anxiety disorders, we would like to suggest the following three mechanisms for this potentially important new approach: 1) MDMA increases oxytocin levels, which may strengthen the therapeutic alliance; 2) MDMA increases ventromedial prefrontal activity and decreases amygdala activity, which may improve emotional regulation and decrease avoidance and 3) MDMA increases norepinephrine release and circulating cortisol levels, which may facilitate emotional engagement and enhance extinction of learned fear associations. Thus, MDMA has a combination of pharmacological effects that, in a therapeutic setting, could provide a balance of activating emotions while feeling safe and in control, as described in case reports of MDMA-augmented psychotherapy. Further clinical and preclinical studies of the therapeutic value of MDMA are indicated.

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1986Emotional processing of fear: Exposure to corrective information.2003Social support and oxytocin interact to suppress cortisol and subjective responses to psychosocial stress 2005A Multidimensional Meta-Analysis of Psychotherapy for PTSD 2003The Pharmacology and Clinical Pharmacology of 3,4-Methylenedioxymethamphetamine (MDMA, “Ecstasy”)2005A Functional Magnetic Resonance Imaging Study of Amygdala and Medial Prefrontal Cortex Responses to Overtly Presented Fearful Faces in Posttraumatic Stress Disorder 2007Social Bonds and Posttraumatic Stress Disorder 2007Cognitive Behavioral Therapy for Posttraumatic Stress Disorder in Women 1999Role of norepinephrine in the pathophysiology and treatment of posttraumatic stress disorder

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