Shirah Vollmer MD

The Musings of Dr. Vollmer

Does ‘Ecstasy’ Live Up To It’s Name?

Posted by Dr. Vollmer on March 17, 2014

MDMA

http://www.latimes.com/local/la-me-mdma-20140316,0,4729638.story#axzz2wFf3Afb4

“By some estimates, as many as 4,000 therapists were using MDMA in their practices before federal authorities banned the drug.”

MDMA, the active ingredient in Ecstasy, heals the traumatized brain, or so some patients and therapists believe. No science exists, only anecdotes. Is it compassionate to try a compound in which the stories sound compelling, even though it is illegal? This is the dilemma posed by this article which grabbed my attention both because of the ethical dilemma, and the intriguing neurochemistry. Let me start with the latter. Can we imagine a chemical which makes traumatic memories, memories from war-torn environments, memories from childhood sexual abuse, somehow seem less shameful and more open to discussion? Yes, I can imagine that. I can see how if the amygdala is suppressed, then the sting, if you will, of the memory is diminished, and thereby a narrative can flow without the obstruction of judgment or horror. As to the ethical dilemma, this is more troubling to me. Both sides of the dilemma make sense. On the one hand, people who are suffering need relief, and sometimes we have to think out of the box to obtain that. On the other hand, science is critical to advancement and so we should advocate for meticulous research before walking into territory which could cause more harm than good. Yes, it is true, that my professors did LSD research on autistic children, to see if the LSD would help with social skills, and so using illicit drugs for medicinal purposes is not a new idea. Yet, these professors used government funding to explore, what turned out to be, a failed experiment. For the clinician to advise MDMA ingestion, without the rigors of a clinical trial strikes me as well-intention, but misguided. The seduction that a medicine or a diet can alleviate human suffering creates an industry of hope and opportunity. If there were no side effects, like our relatively new gluten-free fad, then I am happy to emphasize the lack of science and encourage people to have their own trial. However, in the case of MDMA, fooling around with brain chemistry is a very scary proposition. I am waiting for the science, even though, as the article reminds us, no one seems to want to fund this. Having said that, I would rather use our current tools than to step over that anecdotal line which says,  “well, it worked for me, and so it might work for you too.” Ecstasy, the drug, in my clinical experience, is a wish for some, true for others, and a nightmare for the rest of the folks. I repeat. I am waiting for good data.

See also ……

Flashback to the 1960s: LSD in the treatment of autism.

Abstract

Between 1959 and 1974, several groups of researchers issued reports on the use of d-Lysergic Acid Diethylamide (LSD) in the treatment of children with autism. This paper reviews that literature to consider how the authors justified these studies, as well as their methods, results, and conclusions. The justification for using LSD was often based on the default logic that other treatment efforts had failed. Several positive outcomes were reported with the use of LSD, but most of these studies lacked proper experimental controls and presented largely narrative/descriptive data. Today there is renewed interest in the use of psychedelic drugs for therapeutic purposes. While this resurgence of research has not yet included children with autism, this review of the LSD studies from the 1960s and 1970s offers important lessons for future efforts to evaluate new or controversial treatments for children with autism.

PMID:

 

17608329

 

[PubMed – indexed for MEDLINE]

2 Responses to “Does ‘Ecstasy’ Live Up To It’s Name?”

  1. Shelly said

    How do you feel about using psychotropic drugs on the young? While it may bring great relief to the patient and their families, not enough research has been published into the long-term effects on developing brains, and still you use the drugs. My opinion is that the use of other means of obtaining relief may be justified if necessary–even if they are not (yet) FDA-approved. LSD or Ecstasy may be dangerous drugs to the general population, but in the hands of a skilled provider, may be justified in some cases.

    • Psychotropic drugs, prescription drugs, that is, have been studied in adults and so you are right that the developing brain adds another layer of complexity, we still have good data to suggest both efficacy and potential side effects.
      Yes, there may be justification for stepping outside of the FDA box, but there is a thin line between “trying everything” and being arrogant. So, yes, in some cases, exceptions have to be made. As a general rule I agree, but how these exceptions are determined is my issue. Thanks.

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