Ask an Expert: Should I Do Ecstasy Therapy?

By Larissa Mooney 02/19/15
Today's question is on if it's a good idea to undergo guided journeys on MDMA with therapists to relieve stress.

I went through rehab four years ago and have been doing pretty well. Recently my mother who is a very difficult person got sick and I took a leave of absence from my job to take care of her. It is oh my God stressful, with lots of nasty comments from her that bring up my childhood issues. I am resisting medicating (I was a downer person and drank). I live in the Bay area and there are two therapists here my friends rave about and go to who take their patients on guided journeys with Ecstasy (they say it is very good MDMA). Both my friends have made a lot of progress with therapy on E and both say I should go and one says I should take my mother. I'd like to get the thoughts of one of your experts who knows a lot about pharmacology as well as therapy. Thank you. - Melissa


Larissa Mooney: Melissa, there has been considerable interest in the use of MDMA to facilitate psychotherapy; recent research has focused on the potential utility of MDMA to augment therapy for post-traumatic stress disorder (PSTD) and anxiety disorders. However, though your friends have had a positive experience with MDMA-guided therapy, MDMA is not approved for this purpose and we do not have sufficient data or regulations to recommend this approach. My initial suggestion is to schedule a clinical evaluation with an addiction psychiatrist to thoroughly evaluate your symptoms and treatment options. There may be other treatments available to help you that pose less risk. I would caution against basing personal decisions on anecdotal reports from friends or loved ones, because individuals may vary widely in their responses to any treatment.  We do not yet know the range of experiences or risks to individuals who participate in MDMA-assisted psychotherapy.

MDMA has serotonergic effects that cause a sense of euphoria, alertness, empathy, and pro-social feelings and behaviors (e.g. friendliness, openness, confidence, and closeness) after use.  MDMA use may also initially improve feelings of trust and dampen fear. In combination, these psychological effects may have clinical benefit in therapy, and preliminary evidence has been demonstrated for MDMA in the treatment of PTSD. However, negative effects of MDMA include jaw clenching and other medical consequences as well as feelings of sadness and distrust several days after use, consistent with effects of serotonin depletion. More research including larger trials would be necessary to delineate the range of potential benefits and consequences of MDMA-assisted therapy.



Larissa Mooney, MD, is the Director of the Addiction Medicine Clinic at University of California, Los Angeles, and is a board certified addiction psychiatrist with expertise in the treatment of substance use disorders and psychiatric co-occurring disorders. She is also Assistant Clinical Professor of Psychiatry at     Full Bio.

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