Some 13 million Americans struggle with post-traumatic stress disorder (PTSD). Existing therapies only bring relief for a fraction of patients, and new treatments are sorely needed, according to psychiatrists wrestling with the scale of the problem. So, there was distinct disappointment when an advisory committee at the US Food and Drug Administration (FDA) voted earlier this month against a therapy that many had hoped could offer the first new treatment for PTSD in 25 years.

A number of experts who study psychedelics have since spoken out in support of MDMA-assisted therapy for PTSD and have sharply criticised the recommendations of the FDA’s Psychopharmacological Drugs Advisory Committee. But some are still optimistic that the treatment might be approved when the FDA delivers its final decision in August.

Ahead of the meeting, FDA approval of MDMA-assisted therapy for PTSD seemed likely, says Sandeep Nayak, an assistant professor of psychiatry at Johns Hopkins University, who investigates psychedelics as treatments for substance use and mood disorders. About two-thirds of people who received three sessions of MDMA and talk therapy no longer qualified for a PTSD diagnosis at the end of two Phase 3 clinical trials.

It’s an outcome that is “almost double that of existing medications”, says Gül Dölen, a neuroscientist at the University of California, Berkeley, who researches the mechanisms of how psychedelics achieve therapeutic effects. “What’s more, [the treatment] led to durable improvements in these patients lasting at least six months.”

  • Fondots@lemmy.world
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    5 months ago

    As a child on a taco commercial once said

    ¿Por qué no los dos?

    Both show promise though need further research to determine how they should be used most effectively and safely, they have similar legal hurdles, and different patients may respond better to one, the other, or possibly even a combination of both,

    • You999@sh.itjust.works
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      5 months ago

      As much as I hate to say this, MDMA being used for treatment of mental illnesses might not be viable option because of it’s negative effects. I do not know if short term severe depression and long term memory loss is worth a reduction in PTSD. Maybe as a last resort medication similar to how methamphetamine is prescribed for drug resistant ADHD.

    • Varyk@sh.itjust.works
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      5 months ago

      As I said, there’s no reason why not two.

      Similarly, there’s no reason to make people wait for a potential mdma medication while psilocybin is available, effective against the exact same symptoms, perfectly safe and has a simpler therapy regimen.

      • girlfreddy@lemmy.caOP
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        5 months ago

        Because not everyone is exactly the same. Different experiences, different histories, different types of injuries/traumas means different methods of treatment.

        Yes psilocybin is good. But it may not be for everyone.

        • Varyk@sh.itjust.works
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          5 months ago

          Nobody argued everyone’s the same.

          All of the arguments that are put forth for using MDMA to treat PTSD symptoms already work for over 80% of patients using a single treatment of psilocybin that is already available.

          Go ahead and research MDMA, but don’t deny people an available, effective, safe and simple treatment while we wait for the development of experimental therapies.

          • treefrog@lemm.ee
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            5 months ago

            Again you’re spouting statistics with no scientific evidence to support them. I remember that study you linked with the 80%. That rate was not for PTSD but other chronic mental health conditions being treated with psilocybin.

            Your claims have no evidence to support them so please stop. Because you’re not helping.

            • Varyk@sh.itjust.works
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              5 months ago

              It’s fine if you didn’t read or don’t like that study.

              Those symptoms resolved by psilocybin are the same as the PTSD symptoms that MDMA hopes to treat one day.

              You not liking a particular medication doesn’t make it less effective or safe for people.

              You might want to check out the news recently though, MDMA is specifically not being approved last weekend this week because a safe therapy has not been found, unlike with psilocybin.

              Psilocybin is safe, simple and effective.

              Controlled studies have born this out.

              • flamingarms
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                5 months ago

                You do know the hope is not to treat symptoms but underlying disorders, right?

                • Varyk@sh.itjust.works
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                  5 months ago

                  That’s close.

                  Ptsd is much more effectively treated when you deal with the symptoms and the disorder itself instead of just focusing on The disorder and ignoring the symptoms.

                  Luckily, psilocybin therapies work on both symptoms and disorders.

                  I mentioned symptoms specifically because MDMA therapies are specifically focused on the symptoms right now that psilocybin already effectively treats.

                  So you can take the effective and perfectly safe psilocybin therapy regimen to alleviate symptoms and the disorder itself while focusing on supplementing that treatment with more traditional therapies to dig deeper into the disorder.

              • treefrog@lemm.ee
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                5 months ago

                I love psilocybin. I used to grow them and still am fond of them and encourage others to explore them.

                But it treating similar symptoms to PTSD is not the same as having an 80% success rate with actual PTSD, which is the claim you’re making and not the claim your study is making.

                PTSD is not anxiety or depression, even if it can present with similar symptoms. Nor is it substance use disorder. It’s trauma and it requires safety and community to unpack.

                Psilocybin is great at helping us develop a deeper relationship with ourselves and life generally. But the hormones released during an MDMA session better facilitate safety and connection.

                Honestly I’m not trying to convince you in particular because we’ve had this conversation before and you’re unwilling to reexamine your own conclusions. But I’ll keep correcting the narrative for others who come along.

                • Varyk@sh.itjust.works
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                  5 months ago

                  I remember you had those blinders about MDMA.

                  It’s easier for you to believe whatever it is you believe than to accept the scientific and therapeutic conclusions that disagree with your beliefs.

                  Ask for slanting the narrative. However you feel like it, yeah go for broke.

                  The numbers and consistent facts make it pretty easy for me to fix your mistakes anyway.

                  • treefrog@lemm.ee
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                    5 months ago

                    There’s so much projection in your post it’s ridiculous.

                    PTSD is not treatable with SSRIs. Depression is.

                    And the logic you are using is that because psilocybin works well for depression it will be great for PTSD.

                    We already know that’s not the case when we look at other drugs used to treat depression and PTSD. Such as the SSRIs I just mentioned.

                    They’re not the same disease and you are drawing false comparisons between the two. I have lived with CPTSD my entire life. I have tried multiple anxiety and depression treatments. And they didn’t work that well, because I have PTSD and not anxiety or depression, those are simply symptoms. And I have taken psilocybin probably 50 times if not more. Because I enjoy it and it helps me clarify my relationship with myself. But it’s not as good at helping me feel safe and connected to other human beings as MDMA is.

                    If MDMA therapy was available I would jump on it tomorrow because I know it would help me more.

                    I’ve been researching this stuff personally for over 30 years. Both through consumption and studying the pharmacology and scientific literature.

                    You seem to be like a first-year psychedelic therapist or something because I remember that class description that you linked, which you completely misinterpreted as well.

                    Does psilocybin have some potential in treating PTSD? Yes. Does the current scientific understanding suggest that it would be better than MDMA for this? No. In fact it suggests that MDMA is superior in treating PTSD. And psilocybin is superior for treating end of life anxiety and depression, assuming these symptoms aren’t being caused by an underlying condition such as PTSD.

                    They are very different diseases. Even if the symptomology is similar, that doesn’t mean the treatment is the same.