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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

#81

Post by randomNumber7 »

BurningFrog wrote: post #42
randomNumber7 wrote: post #31

Earlier quoted context omitted.

Its not like "I know a guy". Its like common knowledge for people who do this stuff that it seriously fucks you up if you do this too often. Its like 100% guaranteed. I would not take this every day for a month even if you offer me a years salary. Every medic who thinks this is a good idea should do the self test in my opinion. The same goes for giving ritalin to kids, but that is a different story...

> I would not take this every day for a month... From the article: The treatment period consisted of three 8-h dosing sessions, in conjunction with therapy, spaced approximately 1 month apart.

Thank you and sorry for not reading carfully enough.

It's still a pretty heavy dosage. Most sane ravers would take less with more time in between. But I guess if you stop after 3 sessions it is ok.

They gave everyone the same dosage without considering the body mass.

Then 120mg as initial dosis for someone who has no tolerance is a crazy kick (considering body mass of ~80kg).

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

#82

Post by randomNumber7 »

OkayPhysicist wrote: post #62
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…

The proposed use is MDMA-assisted therapy. Take a dose, talk to a therapist. Wait a month, repeat. You seem to be imagining people popping the stuff like SSRIs. Intuitively, this makes a lot of sense. MDMA is a fun drug because of the fact that it makes it basically impossible to feel negative emotion under its effect. PTSD is characterized by extreme negative emotion around a particular trauma, to such an extent tha…

Yes that makes more sense. I can imagine that could work. Do you know how it compares to therapy with hypnosis?

There are multiple psychologist in my family, so maybe thats why im opposed to doing therapy with drugs unless physically necesarry.

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

#83

Post by ethanbond »

randomNumber7 wrote: post #56
ethanbond wrote: post #36

Earlier quoted context omitted.

> Its like common knowledge Why don't you just say folk wisdom? Commonly rumored? Calling something "knowledge" doesn't make it such. The entire point of science, and the reason it's so ridiculously hard, is that common knowledge is so frequently wrong. > I would not take this every day for a month even if you offer me a years salary. Then don't? No one is asking you to, nor is this trial nor the proposed line of tre…

I'm also I since guy, so I'm not against what you are saying. Your just twisting my words. You know the story of mdma? It was developed for medical use... And I sayd im skeptical of this, because I cannot imagin, that any serious study, considering the risks comes to this conclusion. Unless it literally stops people from suicid. But as far as I know it's more probable to increase this risk so idk.

But dude, that's the whole point of these studies! It's really hard to know what a given drug does! We should absolutely factor in people's subjective experiences and recreational experiments in terms of deciding whether it's worth investigating something more thoroughly, but once real, high-quality studies are done (especially RCTs), people's recreational experiences hold very little water when they are in conflict with the study.

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

#84

Post by randomNumber7 »

ethanbond wrote: post #83
randomNumber7 wrote: post #56

Earlier quoted context omitted.

I'm also I since guy, so I'm not against what you are saying. Your just twisting my words. You know the story of mdma? It was developed for medical use... And I sayd im skeptical of this, because I cannot imagin, that any serious study, considering the risks comes to this conclusion. Unless it literally stops people from suicid. But as far as I know it's more probable to increase this risk so idk.

But dude, that's the whole point of these studies! It's really hard to know what a given drug does! We should absolutely factor in people's subjective experiences and recreational experiments in terms of deciding whether it's worth investigating something more thoroughly, but once real, high-quality studies are done (especially RCTs), people's recreational experiences hold very little water when they are in conflict…

Yes I also misunderstood the usage. They make a therapy session once a month where the patient gets high before the session.

On the other hand, they dont factor in the body mass of the patient and give everyone the same dosage. That doesnt seem high quality to me. And 120-180mg isn't just a little. Thats at the upper end of what you would take when you go to a party, just for reference. Give this to someone with 60kg body mass and they can have a very bad experience.

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

#85

Post by randomNumber7 »

ethanbond wrote: post #36
randomNumber7 wrote: post #31

Earlier quoted context omitted.

Its not like "I know a guy". Its like common knowledge for people who do this stuff that it seriously fucks you up if you do this too often. Its like 100% guaranteed. I would not take this every day for a month even if you offer me a years salary. Every medic who thinks this is a good idea should do the self test in my opinion. The same goes for giving ritalin to kids, but that is a different story...

> Its like common knowledge Why don't you just say folk wisdom? Commonly rumored? Calling something "knowledge" doesn't make it such. The entire point of science, and the reason it's so ridiculously hard, is that common knowledge is so frequently wrong. > I would not take this every day for a month even if you offer me a years salary. Then don't? No one is asking you to, nor is this trial nor the proposed line of tre…

> I have a better proposal: how about they do a bunch of solid RCTs on it?

Good but somehow a lot of medics give ritalin to kids. If you would buy some ritalin, and also some speed. Try both and realize it is pretty similiar.

I know someone in his mid twenties who has a tremor in his left hand because he had to take this since the age of 10.

And maybe there are cases where it makes sense. But defenitely not in that amount. Idgaf about what anyone tells me about this.

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

#86

Post by theptip »

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.

Right, but if you observe a high enough effect size, it’s in some sense irrelevant whether there was a placebo arm. If somehow there is a reliable d=0.4 placebo effect, then that is just as good as if the drug “really works”. To be clear on magnitudes, there was a something like 70% increase in the treatment effect vs. therapy+placebo.

Indeed what does it even mean for the cure to be “just in your head” or “a placebo” if condition is purely psychological, the trauma is resolved, and there is no remission? It’s a very different game vs. a mechanistic acting drug which either does or does not reduce cholesterol or whatever.

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

#87

Post by theptip »

notamy wrote: post #9
prashp wrote: post #5

Earlier quoted context omitted.

But also > Seven participants had a severe treatment emergent adverse event (TEAE) (MDMA-AT, n = 5 (9.4%); placebo with therapy, n = 2 (3.9%)).

Yep! I do wish they clarified what exactly that means; perhaps I just missed it in my quick read.

See table 2: https://www.nature.com/articles/s41591-023-02565-4/tables/2

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

#88

Post by tmpX7dMeXU »

chadd wrote: post #41
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.

Talked to a therapist at the MAPS conference who said that the way you know a patient is in the trial is about halfway through their therapy session, they inevitably say, "But enough about me, how are YOU doing??"

That is the most MDMA thing ever.

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

#89

Post by theptip »

Alupis wrote: post #53
singingfish wrote: post #51

Earlier quoted context omitted.

aah research impeded by morality police, understand now, thanks

That may not necessarily be the reason. It could simply be until recently nobody believed there could be positive medical uses for MDMA specifically. Not all recreational drugs have legitimate medical uses, or are better than existing medically prescribed drugs. After our current opioid crisis, it's not unreasonable to assume research on opioid medical usage will decline or stop - outside what has already been studie…

No, the war on drugs was definitely the reason, and it was stated as such at the time. They were doing PTSD research with veterans in the 70s and the feds shut it down even though it was clearly promising.

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

#90

Post by theptip »

Alupis wrote: post #33
mountainriver wrote: post #7

Overall seems positive, some interesting pieces: > The only measured exploratory covariate with a significant interaction with treatment was lifetime history of SSRI use, which was associated with improved efficacy of MDMA-AT (P = 0.02; Supplementary Table 5). Covariates significantly impacting the main effect were sex assigned at birth and baseline Beck Depression Inventory (BDI)-II score; female sex assigned at bir…

> That being said, for people with severe PTSD this is surely a godsend. This seems a bit of a premature statement. The long term usage affects of MDMA use can be very costly, and I suspect long term use of something that provides artificial "feel good" emotion will have a tremendous downside for people who are already struggling with normality. > sex assigned at birth... female sex assigned at birth As an aside - in…

You are aware of intersex/chromosomal conditions and “gender assignment” treatments at birth right? “Sex assigned at birth” is a well-defined empirical label.
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