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MDMA-assisted therapy for PTSD: A randomized, placebo-controlled phase 3 trial

nature.com

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Re: MDMA-assisted therapy for PTSD: A randomized, placebo-controlled phase 3 trial

#21

Post by yieldcrv »

randomNumber7 wrote: post #10

Even as someone who has used this recreational, I'm very sceptical about mdma for medical treatment. I have seen smart people needing professional help for a very long time after using this too often. And too often is already every second weekend, because the body needs so long to restore the serotonine. But maybe they are using very little doses? I can still not believe that taking this regularily is a good idea. Ed…

nobody knows the correct dose because nobody could do the trial

it could be anything in any interval or nothing

we have FDA approved treatments that say “don’t do this for more than 2 years” and at the very least we can make objective choices because the side effects are listed… because those also occurred to an actual human being in a controlled environment

I can’t advocate for ignorance like this

Re: MDMA-assisted therapy for PTSD: A randomized, placebo-controlled phase 3 trial

#22

Post by johndhi »

fshbbdssbbgdd wrote: post #16

I’m skeptical that a placebo control for MDMA can be valid. The effects of MDMA are pretty noticeable. The study actually asked participants if they thought they were on MDMA, and most answered correctly. If the participants can tell, it somewhat defeats the purpose of having a placebo control group.

Rick Doblin has some talking points on this that I found fairly compelling... but now I can't find them. Basically that their trial is as good as you can do given that.

Re: MDMA-assisted therapy for PTSD: A randomized, placebo-controlled phase 3 trial

#23

Post by hinkley »

bbatha wrote: post #18
randomNumber7 wrote: post #10

Even as someone who has used this recreational, I'm very sceptical about mdma for medical treatment. I have seen smart people needing professional help for a very long time after using this too often. And too often is already every second weekend, because the body needs so long to restore the serotonine. But maybe they are using very little doses? I can still not believe that taking this regularily is a good idea. Ed…

> And too often is already every second weekend, because the body The intended therapy is taken several times in a guided sessions, 3 for this study, with a therapist. They aren't just sending people home with a bottle of mdma to take before bed.

Yeah my impression of a therapeutic setting would be an asymptotic progression of a few doses in short intervals with an exponential back-off ending in no further uses or perhaps once a year.

Resets are not a recurring situation. I'd take it as a sign of using the treatment in bad faith.

Re: MDMA-assisted therapy for PTSD: A randomized, placebo-controlled phase 3 trial

#24

Post by ethanbond »

carimura wrote: post #14
ethanbond wrote: post #13

Earlier quoted context omitted.

If only there were some mechanism by which we could separate people's personal vibes and anecdata from actual scientific understanding... perhaps a series of clinical trials? History will look unkindly upon people who kept these substances out of the hands of people who need them because "I knew a guy once who did too much street MDMA and went stupid." Honestly, adopting that position in the face of a well-designed P…

rave massage circles?

Exactly. Just gotta work The Truth out through the fingertips

Re: MDMA-assisted therapy for PTSD: A randomized, placebo-controlled phase 3 trial

#25

Post by TylerE »

fshbbdssbbgdd wrote: post #16

I’m skeptical that a placebo control for MDMA can be valid. The effects of MDMA are pretty noticeable. The study actually asked participants if they thought they were on MDMA, and most answered correctly. If the participants can tell, it somewhat defeats the purpose of having a placebo control group.

My understanding is that in trials like this they’ll usually use a benzodiazepine as the control. Not psychedelic, but psychoactive enough that a drug-naive person wouldn’t know for sure what they were on.

Re: MDMA-assisted therapy for PTSD: A randomized, placebo-controlled phase 3 trial

#26

Post by johndhi »

singingfish wrote: post #8

I've been hearing about this for a long time - probably since the late 1990s, so I'm surprised to see that it seems only in the last couple of years that there are phase three trials. I would imagine that the safety profile of MDMA is already well understood / fairly well researched in the 1950s and 1960s

Not really. Research almost entirely paused until the last few years.

Re: MDMA-assisted therapy for PTSD: A randomized, placebo-controlled phase 3 trial

#27

Post by [deleted] »

randomNumber7 wrote: post #10

Even as someone who has used this recreational, I'm very sceptical about mdma for medical treatment. I have seen smart people needing professional help for a very long time after using this too often. And too often is already every second weekend, because the body needs so long to restore the serotonine. But maybe they are using very little doses? I can still not believe that taking this regularily is a good idea. Ed…

[deleted]

Re: MDMA-assisted therapy for PTSD: A randomized, placebo-controlled phase 3 trial

#28

Post by hinkley »

fshbbdssbbgdd wrote: post #16

I’m skeptical that a placebo control for MDMA can be valid. The effects of MDMA are pretty noticeable. The study actually asked participants if they thought they were on MDMA, and most answered correctly. If the participants can tell, it somewhat defeats the purpose of having a placebo control group.

If you start with people who know what MDMA feels like, I suspect you're sunk for the reasons you state.

But if for instance the placebo were niacin... niacin makes most people feel funny. If you don't know what MDMA or a niacin flush feels like, you might just know something is happening but not what.

And then you test people who don't experience niacin flush with or without a placebo to make sure that niacin isn't a therapeutic chemical.

Re: MDMA-assisted therapy for PTSD: A randomized, placebo-controlled phase 3 trial

#29

Post by MAGZine »

fshbbdssbbgdd wrote: post #16

I’m skeptical that a placebo control for MDMA can be valid. The effects of MDMA are pretty noticeable. The study actually asked participants if they thought they were on MDMA, and most answered correctly. If the participants can tell, it somewhat defeats the purpose of having a placebo control group.

It's a control. A baseline. That's the whole point. And especially with the therapy trials they're running, its not like it'll hurt people to have been given a placebo (unlike if you were to say, trial an HIV antiviral with a placebo)

Re: MDMA-assisted therapy for PTSD: A randomized, placebo-controlled phase 3 trial

#30

Post by Glench »

randomNumber7 wrote: post #10

Even as someone who has used this recreational, I'm very sceptical about mdma for medical treatment. I have seen smart people needing professional help for a very long time after using this too often. And too often is already every second weekend, because the body needs so long to restore the serotonine. But maybe they are using very little doses? I can still not believe that taking this regularily is a good idea. Ed…

As other commenters have noted, this is MDMA-assisted therapy. Controlled dose, setting, with supportive professionals.

But one interesting thing to note:

> Least squares (LS) mean change in CAPS-5 score (95% confidence interval (CI)) was −23.7 (−26.94, −20.44) for MDMA-AT versus −14.8 (−18.28, −11.28) for placebo with therapy (P The placebo group got better, too! What this means is that therapy for PTSD actually works! It just works better on average with MDMA assistance.

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