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Medicine PTSD

mr peabody

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Ibogaine and PTSD: My experience

by Tim Williams

I suffer from PTSD, and quite a severe level. I have severe depression with suicidal ideation, short term memory issues, anticipative anhedonia, and aversion to interacting with other members of the public. There ARE some things you can look at that may be of considerable help. I have extensive, personal experience with each, and they've all helped me to great degrees.

The curative abilities of psychedelics are well-documented and have been noted since the 1960s. Specifically, low-dose psilocybin provokes neurogenesis (neuron birth) in the hippocampus. This is significant since the hippocampus shrinks in profoundly depressed and anxious people. Short term low-dose psilocybin has been shown to cause fear extinguishment, i.e. cessation of the nervous response when exposed to a trauma trigger. I can vouch for this being of considerable benefit for me right now. MDMA and LSD also have effects, though slightly different. LSD is known to weaken depression and addictive/compulsive behaviours, and MDMA was one of the most effective tools in psychoanalysis until it was banned as a party drug. Single or intermittent use of DMT is also known to be of benefit - this one, personally, completely cured fear of dying on my first go.

Ibogaine is a psychedelic but a very unusual and interesting one. It has a number of effects on a number of receptors, with stunning and profound results. One of its uses is in drug addiction, where it is up to 20x more effective than traditional detox programs. The OTHER use, which is intertwined with the anti-addictive effects, is in non-psychotic depressive disorders.

Its multi-pronged action simultaneously resets opiate receptor tolerance; floods the brain with dopamine, leading to re-regulation of disturbed dopaminergic effects such as anhedonia; has profound NMDA inhibitory effect (which is a whole new area of anti-depressive research right now, and also allows you to re-process traumatic memories); is a stimulant (cures brain fog and lethargy); is an SSRI (cures depressive behaviours); and last but not least, it up-regulates production of BDNF. BDNF is a growth factor which causes neurons to re-sprout and repair - think a bare tree growing new leaves. Further, taking the full flood dose of 25mg/kg gives you a fascinating 20 hour trip in which you have unparalleled access to all your memories (thanks, NMDA inhibition) and can literally re-visit and gain insight into any part of your life. This has been called "2 years of intensive therapy in a single day."

Ibogaine can be dosed as the psychedelic flood dose, but that requires medical preparation, a minder, and is quite rough as a trip - expect nausea and ataxia. However it's rewarding enough that many people do it once a year just for the incredible insight into one's self that it brings.

The way I tend to use it is microdose. This is a 50mg dose per day, in a 7 days on, 3 days off pattern. The dose is not psychedelic at this point. You don't notice it affecting you at all, but it IS there doing its work... and by the second week you will definitely start to notice significant improvements in many areas.
 
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Aeon Psyche

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Everyday use of mdma is rediculous which makes it impossible as a medicine for PTSD. I suffer from it and it helps in the greatest way while on it but mdma can't be used so very often or you will hit depression and possible other negative side-effects.
 

mr peabody

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MDMA therapy achieves an astounding 76% success rate for treating PTSD

by Rich Haridy - November 1st, 2018

Newly published results from a Phase 2 clinical trial into the efficacy of MDMA-assisted psychotherapy in treating post-traumatic stress disorder (PTSD) have revealed striking success, with 76 percent of subjects not meeting the standard clinical criteria for PTSD 12 months after receiving the treatment.

This latest study is one of six key Phase 2 clinical trials that were used to last year convince the FDA to grant the landmark MDMA-assisted treatment a Breakthrough Therapy Designation. This particular trial, sponsored by the Multidisciplinary Association for Psychedelic Studies (MAPS), was conducted in Boulder, Colorado and led by psychotherapist Marcela Ot'alora.

The trial comprised 28 subjects, all with clinically diagnosed PTSD that had persisted for an average of almost 30 years, despite attempts with other conventional treatments, including drugs and psychotherapy. The structure of the treatment resembled the model established by MAPS in other trials: two day-long MDMA treatment sessions followed by integrative therapy sessions. A third MDMA session was also offered to evaluate whether that improved long-term responses compared to two sessions.

Responses to the treatment were evaluated using the Clinician Administered PTSD Scale (CAPS-IV), the current best standard for PTSD assessment. Here the results were nothing less than spectacular. On enrolment the average CAPS-IV score of each participant was 92, and at a follow-up 12 months after the final MDMA session, the average CAPS-IV score was just 31. A remarkable 76 percent of participants, after 12 months, did not meet the clinical diagnostic criteria for PTSD.

These impressive results bode well for the long-term staying power of the treatment, with the average CAPS-IV score dropping an additional 9.6 points from the point the treatment finished to the 12-month follow-up.

The final stage before MDMA for PTSD can become an FDA-approved treatment is expansive Phase 3 trials. These trials kicked off in September 2018, after a slight delay in producing and encapsulating the MDMA needed to conduct the experiments. Encompassing between 200 and 300 subjects across 16 different sites in the US, Canada and Israel, it should take up to two years to complete this final stage, with ultimate FDA approval on track for sometime in 2021 if all goes well.

https://newatlas.com/mdma-ptsd-successful-trial-results/57074/
 
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mr peabody

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Ships in Distress in a Raging Storm c1690 by Ludolf Backhuysen


MDMA-assisted psychotherapy for PTSD may have benefits beyond reduction in clinical symptoms

by Eric Dolan | psypost.org | May 7, 2019

New research suggests that MDMA-assisted psychotherapy for post-traumatic stress disorder is associated with several beneficial side effects. In addition to reductions in PTSD symptoms, the treatment may be associated with lasting personal benefits and enhanced quality of life, according to research published in the Journal of Psychoactive Drugs.

“Through my work as a clinical psychologist, I have often witnessed the distress, difficulty functioning, and depleted quality of life associated with severe PTSD for many individuals. Additionally, I have seen the difficulty with which many individuals with PTSD have going through traditional treatments for PTSD,” said William Barone, a clinical psychologist and the senior qualitative researcher on the study.

“I had also been interested in the potential of psychedelic and psychoactive compounds to aid in the therapy process, and the first few phase 2 clinical trials confirmed that MDMA-assisted psychotherapy can have a profound effect on PTSD symptoms beyond anything seen in traditional pharmacotherapy or psychotherapy.”

“I took to develop qualitative research in this field for a number of reasons. There had not been any published qualitative studies in MDMA-assisted psychotherapy for PTSD, and it seemed to be a great opportunity to explore the qualitative perspective that I believe is very important in such a study.”

“While quantitative measures are important for showing that a treatment works and that it is safe, in treatments as nuanced as MDMA-assisted psychotherapy, they can have difficulty picking up key details to understanding how and why the treatment may be effective,”
Barone told PsyPost.

“In addition to gaining that nuanced picture, qualitative studies give the participants a voice, and provide insights into how people are affected in very real ways through their participation in the treatment.”

A clinical trial recently tested the safety and effectiveness of MDMA-assisted psychotherapy in 26 military veterans and first responders with PTSD. For the new study, the researchers interviewed 19 of the participants one year after the end of the trial.

“The Phase 2 clinical trials of MDMA-assisted psychotherapy for treatment-resistant PTSD have shown strong reductions in PTSD symptoms over the year following treatment. Based on our study, there appear to be additional benefits to this treatment beyond reduction of PTSD symptoms,” Barone told PsyPost.

Besides reductions in their PTSD symptoms, many of the participants said that the therapy had led to improvement in their self-awareness and social functioning. The therapy also motivated the participants to try new things and reduced the use of both prescription medication and illicit substances.

The participants also expressed being more open to exploring other treatment options following MDMA-assisted psychotherapy. Prior to the clinical trial, many participants expressed very little motivation to continue any treatments for PTSD or other ailments (as is common in individuals with treatment-resistant PTSD).

“Importantly, even the one participant in our sample who was seen to have not benefited from the treatment, displaying less than a 10% reduction in PTSD symptom scores at one year post-treatment, noted that ‘there is improvement from every one of my problems I had when I first came here. Definitely improvement,'” Barone explained.

“The other major take-away from our article is the importance of qualitative investigations in clinical trials, but especially in the psychedelic sciences. Human experience is generally far too nuanced to be captured by t-scores. Especially when the treatment involves ineffable altered states.”

But the study — like all research — includes some limitations.

“The major caveat with most qualitative studies is that they tend to be based on small samples, and even as such are very time and resource intensive. This means it can be difficult to generalize the results,” Barone explained.

“Furthering the difficulty in generalization, the sample included limited diversity, focusing mainly on War Veterans, but also police and firefighters with trauma in the line of duty.”

“However, qualitative studies do not seek generalizability, but rather seek knowledge on an individual level to understand the experience of a phenomena. In recognizing that these experiences took place we have a better understanding of what to look for in future studies,”
Barone said.

Last year, the Multidisciplinary Association for Psychedelic Studies (MAPS) began efforts to recruit volunteers with severe PTSD for Phase 3 clinical trials of MDMA-assisted psychotherapy.

The recent surge in scientific studies on psychedelics has led to a new interest in qualitative research as well.

“Following this publication there has been an increased interest and focus on developing qualitative research in the psychedelic sciences,” Barone said. “We are especially interested in finding graduate students looking to complete theses and dissertations on similar studies, and will be training researchers to do this work on a range of studies in the coming months.”

 
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mr peabody

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You have the right to try psychedelics

by Brittany Hunter

So long as patients are trying a drug of their own volition and free will, no government should stand in their way.

Suffering from PTSD can feel like you are trapped in a prison built of your own horrific memories. Being held captive within your own mind is a unique form of torture since you can’t run away from it or simply think happier thoughts. The darkness follows you in all things, waiting to be triggered. Something as simple as a smell or a sound is enough to flood your mind with unpleasant memories until you feel as though you are drowning in them.

Once that trigger is pulled, those suffering may say and do things they would not normally do. Locked in survival mode, the mind goes into a state that is trapped somewhere between reality and the realm of memory.

In the United States, it is estimated that during the course of a given year, 5.2 million adults experience Post-Traumatic Stress Disorder. Currently, the only legal treatments available for sufferers of PTSD are prescription anti-depressants and anti-anxiety medications. While these may help curb symptoms of PTSD, the medications themselves come with pages of unwanted side effects, including the very real possibility that these drugs will actually make the situation worse. It is also all too common for these medicines to cause a sufferer to take their own life.

Not to mention, anti-depressants and anti-anxiety medications usually serve to numb the unpleasant feelings. While this helps improve the patient’s mood while taking the medication, it doesn’t help them actually deal with the issues that are causing the discomfort.

Of course, this doesn’t mean that better treatments don’t exist. But it does mean that sufferers would be viewed as criminals if they were to try alternatives not sanctioned by the federal government.

But luckily, after years of persistent pressure from MAPS, the FDA is well along in the approval process for the psychedelic drug methylenedioxymethamphetamine (MDMA). And while the FDA’s newfound acceptance of the substance is definitely a sign of progress, it’s far from perfect. What is, perhaps, most infuriating about the FDA’s decision is that it asks sufferers to wait years for a drug that could dramatically improve their diagnosis after only a few uses.

A "Breakthrough" Treatment

MDMA has been found to have “breakthrough” therapeutic qualities for treating PTSD.

In fact, after the second phase of trials conducted by MAPS, 61 percent of the 107 participants no longer qualified as having PTSD. What is more astonishing is that these results were obtained after only three sessions of MDMA being administered. Also worth mentioning, the participants accepted into this study had treatment-resistant PTSD averaging over a time of 18 years.

In other words, these were patients who for years had seen little to no improvement with traditional methods of treatment. Yet, with just a few doses of the drug, the majority of participants saw life-changing improvements.

MDMA works by increasing levels of serotonin, dopamine, and norepinephrine within the brain and then blocking those chemicals from reuptake. This results in a rush of euphoria and empathy and enhanced emotional and physical sensations. When patients are in a state where they are more at ease than usual, it is easier to address past traumas head-on.

When taken in smaller doses than are typically ingested for recreational use, patients are able to work through the issues that have been holding them back for far too long.

Of course, this information isn’t new. It has been around for decades. But it is the first time the government has bothered to pay attention.

State control

For more than 30 years, organizations like MAPS and scholarly individuals like the psychedelic researcher Dr. James Fadiman have been doing their utmost to spread information on the healing powers of psychedelics like MDMA. However, any progress made towards the accepted use of psychedelics in the field of mental health was completely halted with the passing of the Controlled Substances Act of 1970.

Nixon was no fan of the hippie, free love drug culture that accompanied the America’s involvement in the Vietnam War. He wanted law and order and, to that end, started America’s War on Drugs.

Unfortunately, his lack of understanding of the subject meant that for years psychedelic research was suspended. Those studies that continued underground in spite of the new policies were viewed as merely anecdotal and given no substantial medical attention.

The Controlled Substance Act categorized psychedelic drugs and even cannabis as being “Schedule 1” drugs. According to the federal government, drugs given this designation have a high potential for abuse and have no accepted medical use.

In 2017, most doctors understand the medicinal benefits associated with marijuana. But even considering all the information that is around today, the DEA has doubled down on its outdated position and refused to remove cannabis from the list of Schedule 1 substances.

If marijuana can’t be removed from the list, it seems far-fetched to believe that the DEA would consider downgrading psychedelics. But, since Trump was elected on a platform of deregulation, many psychedelic researchers and activists are hopeful.

Rick Doblin, executive director of MAPS, stated:

"I do feel very optimistic. One of the Trump administration's main things is lower regulation. They're pro business and pro making it easier for Big Pharma to get drugs through the FDA. And that benefits us."

However, while this is great news for psychedelics like MDMA, the benefit of having Big Pharma anxious to make a profit does not bode well for other psychedelics, like Lysergic acid diethylamide (LSD). As Doblin pointed out in a statement he made in 2012, substances like LSD and psilocybin (magic mushrooms) are “off-patent, can't be monopolized, and compete with other psychiatric medications that people take daily."

Unfortunately, this makes its medical use unappealing to pharmaceutical companies. Much like marijuana, which can be cultivated by individuals in their home, big pharma has almost nothing to gain from the legality of these substances. In fact, they have everything to lose since research suggests that psychedelics could remove the need for long-term use of anti-depressants and other drugs associated with improved mental health.

But the legality or government approval status of a drug or substance should not determine whether or not an ailing mental health patient has the right to try experimental treatments. Just as terminally ill patients have advocated for “right to try” policies that would allow them to use experimental drugs not yet approved by the FDA, so should mental health patients be able to try psychedelics at their own risk.

The Right to Try

Headlines touted how wonderful it is that as soon as 2021, MDMA may be available by prescription to those who need it most. While this is most certainly a giant step forward, it is also appalling that those suffering are being asked to wait for a potentially life-changing remedy.

“Right to try” policies are typically crafted for patients who are suffering from a terminal illness and allows them to try experimental treatments. While advocating for “right to try” laws have been an uphill battle, the movement has grown in support over the last several years.

Logically, it follows that if someone has been given a terminal prognosis, the individual in question should be allowed to try experimental treatments regardless of the possible negative side effects. While this is justified by concluding that the patient is already going to die so there is no harm in experimentation, this practice should be extended to all consenting adults.

Each individual is the sole owner of his or her body. As such, no governing body has the legitimate authority to tell a person what they can and cannot consume. Yet, over the course of history, governments have decided that it is their duty to ensure that mankind only consumes substances given an official stamp of approval.

The FDA, the agency responsible for dictating what Americans can safely consume, is the same agency that claims Poptarts are healthier than avocados. When this is partnered with the fact that the DEA has routinely ignored scientific evidence that marijuana has medicinal properties, one has to wonder why this authority has not yet been removed.

Suffering from mental ailments or chronic diseases takes a tremendous toll on the sufferer. When your quality of life is in decline because of these daily struggles it is nothing less than evil to prohibit patients from experimenting with different treatments. The drugs that have been approved for medical use, anti-depressants for example, come with a huge risk of side effects including death.

Psychedelics, on the other hand, have fewer physical side effects and are proving themselves to be more impactful for treating varieties of depression. Yet, because of the illegality of these schedule 1 drugs, any patient caught trying MDMA or LSD outside of a government-sanctioned study is a criminal in the eyes of the law.

Something has to change.

So long as patients are trying a drug of their own volition and free will, no government should stand in their way. Every time we consume anything, even food, there is risk associated. Nothing in life is risk-free. But when you are suffering on a daily basis, that risk is mitigated by the need to live a more fulfilling and happy life.

“Right to try” laws should be championed. Those suffering from mental illness deserve the chance to heal today, not four years from now.

 
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mr peabody

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Could MDMA help with PTSD, depression and anxiety?

by Jesse Noakes | The Guardian | Apr 13, 2019

As Australia’s first trial for psychedelic therapy for terminally ill patients gets under way, a growing movement says it could also help other conditions,

In August 2016 I went to New York for the first time. On the second evening, I was sitting on a long couch on the top floor of an old church. All around me instruments were scattered on the floor – singing bowls, tuning forks, rainsticks, Tibetan bells. At the foot of a wall, carpeted completely in moss, was a large bronze gong.

On the table in front of me two small ceramic bowls contained a capsule of 125mg of pure MDMA and a chilli guacamole with three grams of powdered magic mushrooms stirred through it. I eyed them nervously. I was terrified that I was going to lose my mind but I was more scared that nothing would happen at all, that I was too broken for even this radical treatment.

I’d left Australia to take psychedelics with a therapist. Almost a decade of regular talk therapies for depression had done little to explain why I still felt so numb, trapped and terrified. A few months earlier I’d tracked down a guy online who said that, while it wasn’t a magic bullet, he might have something that would help. I can’t name him because it’s still completely illegal.

He was sitting across from me and after I’d swallowed the contents of both bowls he handed me a padded eye mask and suggested I lie back on the couch. I heard him move across the room in the steamy darkness as I tried to relax and focus on my breathing. Moments later I heard the first strange notes from the gong.

2016 was a breakthrough year for psychedelic therapy, not just for me. In May, a study from the Beckley Foundation in partnership with Imperial College London found that two-thirds of their participants with treatment-resistant depression were in remission a week after a therapy session with psilocybin, the active chemical in magic mushrooms. One participant said: “I found I felt more connected, to myself, other people, nature, life in general. I felt alive, rather than distant and isolated and cut off.”

In November 2016 two US university studies jointly published their findings: 80% of the terminally ill patients who had similar psilocybin sessions experienced significant reductions in depression and anxiety.

The following week the US Food and Drug Administration announced that it was approving the final phase of trials of psychotherapy for post-traumatic stress disorder (PTSD) using MDMA.

Meanwhile, in Australia – nothing. At the end of 2015 Psychedelic Research in Science and Medicine (Prism), a non-profit research association formed in 2011, had its second application for a study of MDMA-assisted psychotherapy knocked back by Deakin University. The email from the deputy vice chancellor for research said: “The university will not engage in research that has the potential to damage its reputation as an ethical organisation.”

Dr Martin Williams, president of Prism and a medicinal chemistry researcher at Monash University, got the message loud and clear. “We realised then that it was going to be a hearts and minds operation on our behalf, that we were going to have to be an advocacy organisation and play the long game,” he says.

The momentum has been building for decades overseas. In 1986 Rick Doblin, a trainee therapist with a PhD from the Harvard Kennedy school, founded the Multidisciplinary Association for Psychedelic Studies (Maps) to overturn the decision by the US Drug Enforcement Agency (DEA) to criminalise MDMA use. Initially a drug used in the 1970s by American therapists to enhance their clients’ feelings of trust and openness during sessions, MDMA’s effects had become too popular to contain and, like LSD a couple of decades before, it broke through into wider culture leading to a blanket ban on recreation and research.

Doblin, a shambling sun-bear of a man with a perpetual smile, initially launched an appeal against the DEA decision through its own legal channels, and won. However, the DEA disregarded the ruling so Maps opted for medicalisation – taking MDMA through several phases of clinical trials to establish its safety and therapeutic efficacy. “I just knew from personal experience, from working with patients, that MDMA was so different, that eventually the truth would come out,” says Doblin. “Did I think it would take 32 years? No.”

It was only last year that the full results of six phase-two trials of MDMA-assisted psychotherapy were published, in Lancet and the Journal of Psychopharmacology. Of 107 patients with treatment-resistant PTSD who were administered the drug in two or three seven-hour sessions, with therapists, eye mask and music, 68% were in remission at the 12-month follow-up. It’s about twice the success rate for the gold-standard treatment for PTSD: prolonged exposure therapy.

MDMA’s therapeutic properties emerge from a combination of factors. Its most acute effect is to significantly dampen the activity of the amygdala, the part of our brain that regulates fear response. While it relieves anxiety and stress, MDMA also sharply increases the brain’s supply of serotonin and oxytocin, the neurotransmitters primarily responsible for mood regulation and social bonding.

A recent study in Nature suggested that MDMA can temporarily return the brain to an early development state of “exuberant brain plasticity” that fosters renewed social reward learning. The American psychiatrist Julie Holland says: “You basically couldn’t design a molecule that is better for therapy than MDMA.”



A former firefighter, Ed Thompson, was overdosing nightly on a combination of booze and benzos when he entered a Maps trial in Charleston, South Carolina, in 2015. The trauma of losing nine colleagues as they fought a warehouse fire beside him, the worst firefighting loss in the US since 9/11, was compounded by a chronic illness afflicting his twin baby daughters.

“My body felt like it was going to explode from the inside out ... I was underwater and drowning,” he told me last year. After three all-day MDMA sessions with two therapists beside him, he no longer met the criteria for PTSD. “It was just an incredible time of healing.”

In 2017 the US Food and Drug Administration declared MDMA a “breakthrough therapy”, and Doblin expects it to be a legal medicine in the US again by 2021. Phase-three trials have begun at 15 sites in the US, Canada and Israel and will roll out across Europe this year after agreement with the European Medicines Agency.

In Australia a proposal for an MDMA trial with just four participants is slowly moving through the approvals process, this time at Edith Cowan University in Perth. Stephen Bright, senior lecturer in addiction studies at the university and vice president of Prism, says it supports the trial, and the wider community is increasingly open to the idea. “The public are generally receptive,” he says. “All the stuff I’m talking about – depression, trauma, addiction – they have been touched by in some way. At the end of the day, the evidence says that psychedelic therapy is effective at treating a range of conditions.”

Nigel Strauss, a Melbourne psychiatrist and trauma specialist who worked with Prism on its failed proposal, says the way psychedelic therapy works is a challenge to prevailing medical assumptions. “Psychedelic drugs are a whole change of perspective,” he says. “These are ‘meaning’ drugs, and the whole concept of meaning eludes people and they think it’s hocus-pocus. These are concepts that don’t fit easily into medical science at the moment … particularly in this country.”

But something has shifted. In January St Vincent’s hospital in Melbourne announced that Australia’s first trial of psilocybin-assisted therapy for 30 people with terminal illnesses will start in coming months. It is believed the mind-expanding and mystical properties of the psychedelic experience might be especially effective at relieving the existential angst and hopelessness that often accompanies a terminal diagnosis. “When you’re working with psychedelics you can reliably expect these deeply embodied transformational moments,” says Rosalind Watts, a clinical psychologist working on the Beckley/Imperial trial.

Williams, who is co-investigator on the St Vincent’s study, which Prism has helped organise, says what has been called the “psychedelic renaissance” overseas is more like the dawning of a new age in Australia, where there is no history of psychedelic research. “It’s definitely a major step forward because … as long as we achieve positive results from the research, then we expect to move that into therapeutic practice in a period of time … perhaps five to 10 years,” he says.

Gillinder Bedi, a senior research fellow at the University of Melbourne who has previously run US studies of the pharmacology of MDMA, says of some advocates: “They are the true believers. Scientists are a little bit uncomfortable with the language that gets used. I don’t think that organisations like Maps coming from the counterculture on the people outside it.”

For Bedi their findings are almost too good to be true: “The results I’ve seen are unique – the effects are really clear. It’s just that they’ve been in small studies and they’ve been conducted by people who have massively vested interests in the whole thing … There’s a part of me that goes, ‘Why did your data end up so neat and nice?’ I’m not sceptical about the rigour of the science, I’m just confused more than anything.”

But Bedi insists that contrary to its reputation MDMA is safe to use therapeutically: “It’s pretty clear now that we can administer it in a controlled environment with appropriate supervision pretty safely.” Psychedelics studies exclude people with a history of psychosis or mania, as well as those with certain medical conditions that the drug effects could exacerbate. “If it’s given to people who are well screened beforehand, those risks can be controlled.”

The Prism team was cagey about the St Vincent’s study until the moment it was announced, but Williams has noticeably relaxed his attitude discussing psychedelics in the Australian context. “I think there’s been a broad shift in the public discourse, which has been this ongoing process, probably since the results of the clinical trials in the US and Europe were first communicated,” he says. “ … It’s thanks to the great groundwork of Maps and others overseas that we’re at the point we are now at all.”

A new non-profit called Mind Medicines Australia launches next month to coordinate training more therapists to meet the potential demand. Williams and Strauss are planning a study of psilocybin for treatment-resistant depression, modelled on UK research.



For more than a decade, the Beckley Foundation has developed groundbreaking psychedelic research in partnership with Imperial College London. They produced the first brain scans of the LSD and psilocybin experience which suggest that, rather than amplifying neural activity as expected, psychedelics appear to selectively inhibit the “default mode network”, which regulates executive brain function like a disciplinarian teacher. When psychedelics take it out of the picture for a period, a whole bunch of new connections and neural activity fires up like exuberant children, allowing a wider range of phenomena to reach conscious awareness. Brain scans of long-term meditators have shown the same pattern.

The novel neural connections facilitated in the psychedelic state can lead to lasting changes. A 2018 Beckley/Imperial study using data from their previous depression trial measured significant increases in the personality domain of “openness”’ three months after the single high dose of psilocybin.

It replicates similar findings from Johns Hopkins University in the US. Albert Garcia-Romeu, who is leading another Hopkins psilocybin study, told me that openness goes hand-in-hand with reductions in symptoms such as rigid negative thinking. “It has shown association with overall happiness and quality of life, so in that regard I think it can be an important piece of the puzzle in terms of psychedelics’ therapeutic potentials,” he says.

Ian Roullier, a participant in the Beckley study of treatment-resistant depression, described how he experienced it: “Depression is a very narrow, restricted state and taking psilocybin really helps you to zoom out a lot more … I felt a lightness within myself and more of a freedom.” Like MDMA for PTSD, psilocybin has just been given “breakthrough therapy” status for treatment-resistant depression and large-scale trials are being rushed through across Europe.

For me, about an hour and a half after I lay down in New York, I took off the eye mask and sat up to a world transformed. For as long as I could remember there had been a wall of glass between the world and me, trapping me in a numb limbo that a litany of talk therapy and medications couldn’t touch.

Like magic, the wall was gone. Everything I looked at had a new clarity and immediacy as I drank it in. It was as though an iron knot of tension in my forehead, which contracted my whole body in its clenching grip, had suddenly dissolved. I felt calm, confident and connected. I didn’t feel like I was tripping – I felt like myself for the first time in years. It was the purest relief I’d ever known.

Almost three years later I’m back living in Fremantle but it’s all changed. I had spent past Western Australian summers in bed, staring at the wall with the blinds down. This year I’m up at five most mornings making the most of the rising sun: gym, swim, long walk on the beach, and in the studio by eight this morning to finish off my edits before uni. I’d always wanted to write but the words wouldn’t come, and while I still have to work bloody hard to keep the show on the road, it’s all flowing now.

 
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mr peabody

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Alexander "Sasha" Shulgin


MDMA shows promise for post-traumatic stress treatment

Neuroscience News | May 30, 2019

An international study involving researchers from UBC Okanagan has shown that MDMA may be a valuable tool for treating post-traumatic stress disorder (PTSD).

Published recently in Psychopharmacology, the study demonstrated substantial improvements in individuals who had not responded to prior treatments, explains UBCO Associate Professor of psychology Zach Walsh. This is also, he adds, the most comprehensive evaluation of the safety and effectiveness of MDMA-assisted psychotherapy for PTSD.

“PTSD symptoms decreased after one session of MDMA together with psychotherapy,” says Walsh, study co-author. He adds that 54 per cent of participants no longer met PTSD criteria after two sessions and that there was also improvement in their symptoms of depression.

The response of participants to MDMA-assisted psychotherapy was compared to those who received small doses or non-drug psychotherapy.

“These findings are promising and indicate the needed for larger studies,” says Walsh.

"Too many people with PTSD struggle to find effective treatment, and use of MDMA in a supportive environment with trained mental health professionals could be an important addition to our treatment options.”

MDMA is a synthetic drug made from a combination of methylenedioxy-methamphetamine. It is a controlled, illegal drug in Canada classified as a stimulant with hallucinogenic properties.

Walsh, as well as researchers from the United States, Switzerland and Israel, examined the results from six clinical trials, involving 103 people. Trial participants included men and women with chronic, treatment-resistant PTSD from a wide variety of causes.

Based on these results, the US Food and Drug Administration granted breakthrough therapy designation to MDMA-assisted psychotherapy for PTSD, acknowledging that it “may demonstrate substantial improvement over existing therapies” and agreeing to expedite its development and review.

The first of two more in-depth clinical trials of MDMA-assisted psychotherapy for PTSD began enrolling participants in November 2018, and aims to have 100-150 volunteers across 15 sites in the US, Canada and Israel. The second trial will take place after an interim analysis of the data from the first trial, and will enrol an additional 100-150 participants. European trials are planned to start in the near future.

Nearly four per cent of all people worldwide will suffer from PTSD during their lifetime. PTSD can be a debilitating disorder, with symptoms including intrusive thoughts and memories, negative effects on thinking and mood, depression, hyperarousal and reactivity, and avoidance. People with PTSD can experience much lower quality of life and relationships, related mental health conditions and suicidal tendencies.

 
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mr peabody

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MDMA therapy achieves an astounding 76% success rate for treating PTSD

by Rich Haridy - November 1st, 2018

Newly published results from a Phase 2 clinical trial into the efficacy of MDMA-assisted psychotherapy in treating post-traumatic stress disorder (PTSD) have revealed striking success, with 76 percent of subjects not meeting the standard clinical criteria for PTSD 12 months after receiving the treatment.

This latest study is one of six key Phase 2 clinical trials that were used to last year convince the FDA to grant the landmark MDMA-assisted treatment a Breakthrough Therapy Designation. This particular trial, sponsored by the Multidisciplinary Association for Psychedelic Studies (MAPS), was conducted in Boulder, Colorado and led by psychotherapist Marcela Ot'alora.

The trial comprised 28 subjects, all with clinically diagnosed PTSD that had persisted for an average of almost 30 years, despite attempts with other conventional treatments, including drugs and psychotherapy. The structure of the treatment resembled the model established by MAPS in other trials: two day-long MDMA treatment sessions followed by integrative therapy sessions. A third MDMA session was also offered to evaluate whether that improved long-term responses compared to two sessions.

Responses to the treatment were evaluated using the Clinician Administered PTSD Scale (CAPS-IV), the current best standard for PTSD assessment. Here the results were nothing less than spectacular. On enrolment the average CAPS-IV score of each participant was 92, and at a follow-up 12 months after the final MDMA session, the average CAPS-IV score was just 31. A remarkable 76 percent of participants, after 12 months, did not meet the clinical diagnostic criteria for PTSD.

These impressive results bode well for the long-term staying power of the treatment, with the average CAPS-IV score dropping an additional 9.6 points from the point the treatment finished to the 12-month follow-up.

The final stage before MDMA for PTSD can become an FDA-approved treatment is expansive Phase 3 trials. These trials kicked off in September 2018, after a slight delay in producing and encapsulating the MDMA needed to conduct the experiments. Encompassing between 200 and 300 subjects across 16 different sites in the US, Canada and Israel, it should take up to two years to complete this final stage, with ultimate FDA approval on track for sometime in 2021 if all goes well.

https://newatlas.com/mdma-ptsd-successful-trial-results/57074/
 
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Another clinical trial finds psychedelics can be used to treat PTSD

by Shamani Joshi | Vice | 21 Jan 2020

New research indicates that people who were given controlled doses of ecstasy and magic mushrooms during post-traumatic stress disorder treatment showed more signs of improvement than those who did not take any drugs.

Psychedelics like LSD, magic mushrooms and MDMA have always been mired in controversy. While some supporters say that they give you great happiness and sex, and take you on a spiritual journey of self-exploration, others advocate avoiding the substances completely, especially if your mind is fragile and easily susceptible.

However, while many studies talking about the usefulness of psychedelics have emerged in a time many are touting as a ‘psychedelic renaissance’, yet another study on the subject shows that they can do more than just make you feel more connected to nature or experience intense euphoria.

New research presented by the Medical University of South Carolina’s Dr Michael Mithoefer says that psychedelics like MDMA and psilocybin mushrooms can be used to treat Post Traumatic Stress Disorder (PTSD), a psychiatric disorder that can occur in people who have experienced or witnessed a traumatic event and whose symptoms include flashbacks, recurrent anxiety and nightmares.

Dr Mithoefer and his team conducted six Phase 2 clinical trials along with independent investigators in four countries. In these trials, one group of patients was given MDMA during their psychotherapy sessions, while the other was administered a placebo or low dose alternative with the same psychotherapy. The findings indicated that those who took MDMA showed more symptoms of improvement than those who did not, proving yet again that psychedelics do have therapeutic advantages.

While scientists have been fascinated with the mind-altering effects of naturally growing psychedelics since the 1950s, the US Food and Drug Administration’s (FDA) crackdown against these substances in the 1970s put a stop to further studies that could prove their therapeutic use. However, since the start of the century, there has been a shift and the FDA has even given MDMA and psilocybin (the active ingredient in magic mushrooms) “breakthrough therapy” designations for treating PTSD and depression respectively. Meanwhile a 2016 study conducted by the Johns Hopkins University in the US, administered high doses of psychedelics to end-stage cancer patients, and found that 80 percent of patients felt free of existential depression and anxiety. This new clinical trial is yet another addition to the list of studies conducted to show that using the thought-provoking, hallucination-inducing psychedelics could after all be the answer to treating trauma-related disorders and depression.

 
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Nicomorphinist

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I find the PTSD situation particularly heartbreaking and I think the way it is being handled in the Western countries in particular is worse than a scandal, worse than a crisis, it may fit the scientific definition of epidemic -- it is a catastrophe from all of the imperialist wars -- and maybe very well from some domestic things (first responders and survivors of the Oklahoma City bombing and both World Trade Centre attacks, Pentagon, Shanksville) and PTSD also starts with some individual things like waking up under anaesthesia and particularly serious and protracted withdrawals from opioid receptor agonists and various other drugs, stalking incidents and other high intensity, high impact emotional experiences.

The whole thing is an abomination. The best of the best volunteer for a nearly impossible job and do it professionally even if politicians are being completely ignorant and insane about what they have to do, and then they come home with this rock to push up the mountain.

I am glad to see that there is some research on peri-exposure chemoprophylaxis protocols to make it less likely. Quite some time ago I figured that some combinations of beta blockers, mild stimulants, and weak to midrange opioids with conservative doses of ketamine may do it, and I would not at all be surprised to hear MDMA helps before, during, and after.
 
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PTSD and MDMA: Science and perception

by Eugene Rubin | Psychology Today | Oct 03, 2018

As part of the search for novel psychotherapeutic drugs, some investigators have started studying several categories of drugs that are commonly abused. Multiple research groups have shown that ketamine can lead to rapid improvement of symptoms in severely depressed individuals. This drug can also rapidly decrease thoughts of suicide. Drugs related to ketamine are in advanced stages of clinical trials, and it is likely that several medications derived from the work with ketamine will be approved within the next few years.

There are also ongoing trials involving psilocybin and LSD for treating anxiety, depression, and substance use disorders. Another recreational drug with possible therapeutic benefits is MDMA. Users report increased empathy and euphoria when using the drug, but it can also have adverse side effects, including elevating blood pressure and increasing cardiac arrhythmias.

In an article published in Lancet Psychiatry, Michael Mithoefer and colleagues reported that MDMA, when combined with psychotherapy in a controlled setting, was effective in reducing symptoms of chronic post-traumatic stress disorder (PTSD) in a small study of military personnel and emergency first responders. This phase 2 study, together with other phase 2 trials, has led the FDA to designate MDMA-assisted psychotherapy as a “breakthrough therapy,” potentially hastening its approval as a treatment. It should be noted that the Mithoefer et al. study was sponsored by MAPS. Although members of this group may have potential conflicts of interests, this study was reasonably well-designed and the evaluators and participants were “blinded” to the dose of MDMA administered. Large phase 3, multisite, double-blind, placebo-controlled trials could soon follow.

Chronic PTSD is a relatively common condition in military personnel returning from active duty. However, it can be a difficult illness to treat. Some individuals respond to antidepressants such as sertraline or paroxetine, and some respond to specific types of psychotherapies. Nevertheless, these treatments do not substantially help many individuals suffering from moderate to severe symptoms of PTSD.

Mithoefer’s group examined the effects of MDMA-assisted psychotherapy in a group of 26 military veterans and first responders who scored above a threshold score on a standardized assessment of PTSD and who had experienced symptoms of PTSD for at least 6 months. (In fact, the mean duration of PTSD in this group of people was 7 years.) Study participants were randomly assigned to receive one of three doses of MDMA —30 mg (7 participants), 75 mg (7 participants), or 125 mg (12 participants) —together with time-intensive therapy. The lowest dose (30 mg) was considered to be an active control. Each person received MDMA on two occasions separated by 3–5 weeks. Prior to the first MDMA session, each individual participated in three 90-minute psychotherapy sessions “to establish a therapeutic alliance and prepare participants for the MDMA experience.”

Administration of MDMA was accompanied by an 8-hour session of “non-directive or client-directed psychotherapy.” This was followed by a week of daily phone contact and two 90-minute sessions “aimed at integrating the experience.” By the end of the first phase of this study, each individual had received about 13 hours of therapy not associated with MDMA and 16 hours of therapy accompanying two MDMA treatments. Each participant was assessed with a standardized scale for PTSD, as well as other standardized assessment scales, one month after the last administration of MDMA. True “blinding” of the participants may have been compromised in that there were different behavioral effects of the 75 mg and 125 mg doses compared with the 30 mg dose.

PTSD symptoms were substantially diminished in those receiving 75 mg and 125 mg MDMA when compared to the group receiving 30 mg. Six of the 7 in the 75 mg group and 7 of the 12 in the 125 mg group no longer met criteria for a PTSD diagnosis; only 2 of 7 in the 30 mg group achieved this level of response. Also, global psychological function substantially improved in those receiving 75 mg and 125 mg in comparison to those receiving 30 mg. Results from 75 mg were at least as good as results from 125 mg.

Following the double-blind portion of the study, those who received the 30 mg and 75 mg doses participated in an open-label trial of three additional sessions consisting of 100–125 mg MDMA and accompanying therapy. Those who received the 125 mg dose in the original double-blind portion of the study received one further session. The substantial improvements that occurred one month after the double-blind phase of the study were maintained a year after the open-label phase of the study.

The MDMA treatments appeared to be well tolerated. One person had a serious side effect involving a temporary increase in a cardiac arrhythmia that was possibly related to the study drug. Few individuals dropped out of the study; 24 of the 26 participants remained in the trial for its entire duration.

The exact mechanisms underlying the possible therapeutic benefits of MDMA are unknown. MDMA has strong influences on various neurotransmitter systems including serotonergic functioning, but relating these effects to treatment of PTSD would be speculative. MDMA is thought to increase openness and trust, and the authors suggest that these properties may enhance the effectiveness of the therapy sessions.

The present results are intriguing but have substantial limitations, including the small sample size, lack of true controls, possibility that therapists and participants were not always blind to doses used, and use of sessions to prepare subjects for the MDMA exposure. The authors indicate that larger phase 3 studies are under development. If these studies confirm that MDMA together with psychotherapy over a period of several months can lead to substantial symptomatic and functional improvement in military personnel with chronic PTSD, it would be an exciting and remarkable finding. Going forward it will also be very important to define the risks associated with MDMA when used for therapeutic purposes.

Exploring the therapeutic potential of counterculture drugs is a fascinating story. A small group of individuals have dedicated their careers to this cause. If research by other disinterested, non-conflicted scientists can confirm their findings, then this group will deserve credit for their persistence despite marked political resistance.

https://www.psychologytoday.com/us/...01810/ptsd-and-ecstasy-science-and-perception
 
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Mike Sinyard


New nonprofit betting on psychedelic therapy

by Caitlin Giddings | Outside Online | 4 Feb 2020

Launched by Specialized CEO Mike Sinyard, Project New Day promotes the use of psychedelics like mushrooms to treat addiction and PTSD.

When Dylan Jouras first agreed to undergo psychedelic therapy, he was apprehensive. But the 26-year-old veteran from San Jose, California, was also ready to try almost anything. It was April 2019, and Jouras was coping with PTSD from two combat tours of Afghanistan that ended in 2012. While deployed, he sustained traumatic brain injuries, shrapnel to the side of his face, and hearing loss. When he got home, constant migraines landed him a Percocet prescription, which later developed into an opioid addiction. Jouras was in and out of recovery and spent five years sleeping an average of three hours a night. Antidepressants numbed him into a shadow of himself. Then his best friend died by suicide, which triggered the worst of Jouras’s memories from combat. “We didn’t think Dylan was going to live through that week,” says Arleen Pietrzak, his mother. That’s when Specialized Bicycles founder Mike Sinyard reached out to the family, saying he knew of a cure for PTSD.

For Sinyard, 70, promoting psychedelic-based treatments had become something of a passion project. Although he doesn’t say whether he has taken magic mushrooms or ayahuasca personally, the bike-industry leader says he’s seen great success with their psychoactive use as an emerging treatment for PTSD, addiction, and depression. Now he’s launching a foundation called Project New Day, which is focused on expanding access to psychedelic-assisted therapies.

Project New Day was actually founded in 2019, but its official announcement last Wednesday was timed to immediately follow a pivotal moment in the fight for legalization. On January 28, the city council of Santa Cruz, California, voted unanimously to decriminalize natural psychedelics, making arrests for use or possession of natural psychoactives like psilocybin mushrooms the lowest priority for law enforcement. The decision puts the city in the company of two others—Denver, Colorado, and Oakland, California—but Sinyard says he expects legalization to expand to the entire state of California and eventually Colorado and New York. Advocates from Project New Day were at the city-council meeting in Santa Cruz, ready to coordinate with local groups to provide education and resources on psychedelic treatments.

The power of psychedelics to combat substance abuse and PTSD isn’t a new cause for Sinyard—it’s one he’s been researching for years as an offshoot of Outride, the foundation he created in 2015 to promote cycling as a nontraditional therapy for ADHD. Outride began with Sinyard’s realization that a bike was an effective tool for combating both his and his son’s ADHD symptoms. But he says pharmaceutical companies had no incentive to fund studies on cycling—it couldn’t be bottled and sold the way Ritalin could. Outride, then called the Specialized Foundation, became an effort to fill in the gaps by partnering with neuroscientists on cycling-based ADHD studies and programs. This year 35,000 kids across the country will go through Outride’s school program, which has since expanded to address obesity, depression, and addiction.

Similarly, Sinyard believes that psychedelic treatments can work in unexplored ways, without the side effects of pharmaceuticals. He told Outside that, after watching people in his life struggle with opioid addiction—and growing increasingly disillusioned with the abuses of Big Pharma companies—he turned to the research of Dr. Gabor Maté, a Canadian physician who has used the plant-based hallucinogen ibogaine to treat addiction. “I’d witnessed it firsthand with the people in my life,” says Sinyard, speaking of the impact of addiction, “and thought, There has to be a better way to help people reset. That’s why we called it Project New Day.”

Sinyard started connecting people he knew who were struggling with substance use with researchers doing similar psychoactive interventions. One of those people was Jouras, whose stepdad was at the time interviewing for a position at Specialized. Jouras and Pietrzak were returning from a frustrating VA appointment with yet another prescription for antidepressants when they got Sinyard’s call and decided to take him up on the offer.

To understand how the therapy enabled the combat veteran confront his PTSD, it helps to know how psychoactives work and what usually happens in a session. “It’s not like people who have these issues can take a bunch of mushrooms and go into the woods and be OK,” says Sinyard. “It’s a very precise way of being ready and working with a therapist who can help you.”

Dr. Alli Feduccia, Project New Day’s leading research scientist and cofounder, has been studying therapeutic uses of MDMA, the active drug in ecstasy and Molly, since 2004. She says the drug releases a number of chemicals, particularly serotonin, which quiets the brain’s fight-or-flight response to fear. This helps lower unconscious defenses around traumatic memories so they can be explored in further detail with a mental-health professional. “Some people describe it as 20 years of therapy in a short amount of time,” Feduccia says. “The discussions are really long—like six to eight hours instead of a 90-minute session—so people can get into a lot of deep material in that amount of time.”

The research outcomes are promising. Feduccia cites six phase-two clinical trials on PTSD that she helped conduct with the nonprofit Multidisciplinary Association for Psychedelic Studies (MAPS) from 2004 to 2017: of the 72 participants who received an active dose of MDMA during therapy, 54 percent no longer met PTSD criteria afterwards. The success rate was more than double that of the 31-person control group, which received similar talk therapy but either without the psychoactive, or with a very low dose. In 2017, the U.S. Food and Drug Administration (FDA) awarded MAPS’ work its Breakthrough Therapy Award, for treating PTSD more effectively than the only currently available pharmaceutical treatment of antidepressants. Two other organizations studying psilocybins for treatment-resistant depression and major depression disorder both received the same award in 2018.

Some of this research has raised concerns about the potential for negative side effects or abuse. In June 2019, the heads of the National Institutes of Health and the FDA responded to an inquiry from Hawaiian senator Brian Schatz as to their findings on psychedelics. Their letter states clearly that the organizations aren’t recommending psychedelic drugs be moved from their classification as Schedule I drugs, or what the DEA classifies as “drugs with no currently accepted medical use and a high potential for abuse.” For MDMA alone, the NIH and FDA heads point to inconclusive data and the potential for kidney and brain damage, among other health risks. But MAPS counters that the letter makes claims based on incomplete, uncontrolled research and animal experiments with too high dosages.

Sinyard knows that some of his advocacy sounds unorthodox. He’s heard it from the families of adult substance abusers for whom he’s tried to propose psychedelics. But he sees a big distinction between taking prescription drugs on an ongoing basis and using a hallucinogen several times in a controlled setting. “The first response from the parent is, ‘This sounds crazy—they already have a drug problem!’” he says. “But these aren’t drugs in the same sense. With an opioid, you take it and you feel nothing—you feel on a cloud. But you take the psychedelic plant medicines, and you’re living through the problem, so there’s no escape.”

For Jouras, breakthrough wasn’t immediate. He started with a holotropic breathwork session, a type of rhythmic breathing designed to achieve a natural, almost hallucinogenic state, then moved on to MDMA-assisted therapy with a doctor. In his first MDMA session, he was able to explore and discuss the trauma surrounding his best friend’s death. By his second session, he could dive into his experiences in Afghanistan and let go of his feelings of self-blame. Now clean, Jouras spoke out about his positive experiences at the Santa Cruz council meeting.

“I think this could save thousands of lives if it became legal and mainstream—and even improve the quality of them, without the side effects of antidepressants and antipsychotics,” Jouras told Outside. “You’re walking around in this zombie shell of yourself when you’re on antidepressants. Yeah, you’re living, but you’re not really living. With psychedelic therapies, especially mushrooms, it’s re-sparking your curiosity and making it so you want to be back in nature and connect to people. Psychedelic-assisted therapy got me living again.”

Project New Day expects decriminalization of hallucinogens to spread across the country, so it’s creating tool kits to educate people on safety issues and preparing materials about how communities can establish peer-recovery and support groups. It’s also working to raise awareness about the research and focusing on getting grants. Board members are particularly excited about the potential for helping veterans and other at-risk populations.

Sinyard will continue to be a believer—and one willing to put his own funds behind promoting the relevant studies. “These are medicines,” Sinyard says emphatically of psilocybin mushrooms and other hallucinogens. “I’m not advocating them for partying but for healing—I’m advocating for the healing potential of these plants given on this earth.”

 
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Portraits of veterans and first responders who have committed suicide.


VA approves psychedelic ketamine for PTSD

by Billy Cox | Herald Tribune | Jun 30 2019

SARASOTA — This month’s decision by the U.S. Department of Veterans Affairs to offer a psychedelic drug to treat post-traumatic stress disorder while marijuana remains off limits is leaving some stakeholders flummoxed amid the ongoing wave of veteran suicides.

Spravato, derived from the family of anesthetic drugs called ketamine and produced by a division of Johnson & Johnson, will be prescribed to VA clients on a case-by-case basis and administered as a nasal spray.

Ketamine variants have made headlines over the decades for their multiple roles as sedatives, recreational hallucinogens and for their impressive track records for mitigating suicidal depression. The Spravato version, which was approved by the U.S. Food and Drug Administration in March, requires patients to remain under professional observation for two hours following ingestion.

The addition of a new remedy for lowering military suicide rates at a moment when retired and active-duty personnel are killing themselves roughly 20.6 times a day was hailed as a milestone by VA Secretary Robert Wilkie. “We’re pleased to be able to expand options for veterans with depression who have not responded to other treatments,” he said in a statement. “It reflects our commitment to seek new ways to provide the best health care available for our nation’s veterans.”

But for those like Sean Kiernan, an Army veteran who attempted to take his life in 2011, the VA’s simultaneous embargo on marijuana is incoherent.

“Ketamine was the most effective drug I’ve ever taken for suicidal thoughts — but it is not a long-term medicine you should use. I got psychologically addicted to it for four years,” says Kiernan, president of the Weed For Warriors Project, which advocates legal cannabis for veterans, with 12 chapters nationwide.

“The danger with ketamine is the side effects, like on your urinary tract and gall bladder. I’ve had three surgeons telling me I need to have my gall bladder removed. My question is, why are you so willing and eager to accept something that, on the face of it, is the very thing you complain about with marijuana, like THC, which isn’t nearly as strong? This is hypocrisy, and it makes no sense.”

Catch-22 for veterans

The nation has been struggling with that contradiction since marijuana was classified as a Schedule 1 drug with the Controlled Substances Act of 1970.

The Herald-Tribune documented the Catch-22 that many veterans find themselves in and the effort of proponents to change the law last year in its “Warriors Rise Up” project.

Despite the fact that more than 2.5 million Americans are legally using medical marijuana for ailments as disparate as fibromyalgia and cancer, all drugs labeled Schedule 1 are regarded as having no medicinal value. Ketamine is a Schedule 2 substance.

CNN reported in February that the military suicide virus is now beginning to sweep the ranks of America’s elite warriors, with U.S. Special Operations Command counting 22 self-induced fatalities in 2018. Eight SOCOM operators took their lives the year before. Also, in April, the self-inflicted gunshot death of a 68-year-old veteran in a VA parking lot in Virginia brought to 22 the number of veterans who’ve killed themselves at VA facilities in the past 20 months.

For researchers like Brad Burge, however, the willingness of establishment medicine to employ psychedelics for the treatment of PTSD and associated psychological issues bodes well for the future of marijuana. “It is good news,” he says. “It shows that things are changing in the acceptance of these drugs for mental illness.”

Burge is director of strategic communications for the Multidisciplinary Association for Psychedelic Studies. Founded in 1986 by New College alum Rick Doblin, MAPS is establishing scientific and legal foundations for the expanded use of psychedelics and cannabis.

The nonprofit research organization is completing Phase 3 trials on MDMA-assisted therapy. That drug, also commonly known as Ecstasy, is a controversial synthetic stimulant banned in 1985. MAPS is also studying the therapeutic applications of LSD, and it hopes to get funding for investigating Ibogaine- and Ayahuasca-assisted therapy.

Early this year, MAPS completed its first study of medical marijuana on 76 veterans diagnosed for PTSD, and will publish its results before the end of 2019. But until cannabis loses its Schedule 1 status, gaining access to acceptable samples of marijuana for the completion of MAPS’ research will be difficult.

“But things are changing,” says Burge. “The heads of all these administrative bodies have acknowledged there are limitations that shouldn’t be there. They don’t want to be put in the position of obstructing legal research.”

*From the article here:

 
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Treating the effects of trauma with cannabis

Michelle Thiessen and Sarah Daniels | CHACRUNA

We are all impacted by experiencing or witnessing traumatic events such as violence, accidents, and the death of loved ones. As we struggle to find ways to deal with the symptoms that can persist in the aftermath of experiencing trauma, cannabis is increasingly being hailed as a potential solution. Nearly 90% of adults in the USA have experienced a traumatic event severe enough to meet criteria for post-traumatic stress disorder (PTSD). Of those of us who experience such a trauma, nearly 10% go on to develop full-fledged PTSD, a disorder that involves difficulty recovering from the traumatic event, and includes feeling irritable and jumpy, avoiding reminders of the trauma, intrusive memories, nightmares, insomnia, anxiety, and a pervasive sense of doom. In some cases, people may even feel as if the traumatic events are happening again. The symptoms of PTSD are severe on their own but are often made worse as sufferers may withdraw from family and friends, engage in problematic substance use, and experience suicidal impulses. Sadly, a sizeable portion of people who have PTSD do not respond to frontline treatments such as medication and psychotherapy. Due to the severity of PTSD, and the lack of effective treatment for many of those who suffer, the potential for cannabis to treat PTSD has been met with much hope and enthusiasm. Although we are not yet at the point where we can decisively say that cannabis is helpful for treating PTSD, research that can help answer this question is underway. As we wait for further results, a number of interesting findings have led scientists to believe that cannabis may help some people who struggle with the aftermath of trauma. In this article, we will take a look at some of the science behind the claims that cannabis can help treat PTSD.

People with PTSD using more cannabis

One way of understanding whether cannabis might help with PTSD is to examine naturally occurring cannabis use among people with PTSD. Surveys clearly show that individuals living with PTSD are more likely to use cannabis than those without the disorder. The behavior of people with PTSD involves efforts to cope with the disorder, and as such, elevated rates of cannabis use may suggest that these people feel that cannabis is helping to relieve their PTSD symptoms. Veterans are more likely than the general public to experience a traumatic event due to the nature of their work, and report using cannabis to help deal with the after effects of military-related PTSD. One survey found that more than half of veterans surveyed reported using cannabis, and one in ten said they used cannabis specifically to relieve symptoms caused by their trauma. Another study of veterans found that those experiencing less symptom recovery from traditional therapies were more likely to use cannabis, and that higher levels of PTSD symptoms are associated with more cannabis use, which may suggest that cannabis is being used to treat more persistent symptoms. Individuals with PTSD also report using cannabis to help with PTSD symptoms such as problems with sleep and mood. Taken together with the many informal reports from organizations that support people with PTSD in using cannabis therapies, the use of cannabis by people with PTSD suggests that cannabis therapies deserve careful examination as potential PTSD treatments.

Cannabinoids and PTSD: Evidence from inside and outside the human body

The cannabinoids most of us are most familiar with are the molecules produced by the cannabis plant, such as THC and CBD. However, our bodies are also equipped with a specialized system that produces its own cannabinoids. That system is called the endocannabinoid system, and it helps to regulate things like sleep, appetite, and our ability to handle stress. Differences in the endocannabinoid system that are associated with PTSD symptoms can help us to understand how plant-based cannabinoids might help with PTSD. While it is not clear whether a disruption in the endocannabinoid system is a result, cause, or combination of both with regard to PTSD symptoms, people who develop PTSD after experiencing a traumatic event have been found to have differences in their endocannabinoid systems compared to those who experience similar events but don’t develop PTSD. For example, an important study of individuals who were in New York during the 9/11 attacks found that those who went on to develop symptoms of PTSD had lower levels of the body’s self-made cannabinoid, anandamide, in comparison to those who did not develop PTSD. Interestingly, anandamide resembles the THC found in herbal cannabis, which suggests that using external cannabinoids like THC may help to supplement the body’s own internal cannabis system.

What do studies with animals tell us about cannabis and PTSD?

Animals also possess an endocannabinoid system and have their own ways of responding to trauma and stress. Studies of cannabis and stress in animals can provide some clues as to how cannabis use may impact stress response and learning in humans. After exposure to trauma, animals exhibit symptoms similar to those seen in PTSD, such as an amplified startle response and an impaired ability to unlearn conditioned fear responses. Previous studies have found that giving a cannabinoid to animals after exposing them to trauma can relieve these symptoms.

How does cannabis help with PTSD?

One of the key ways that cannabis may help people with PTSD is by improving sleep. Cannabis use can impact dreaming, and among those with PTSD, it may help to reduce the frequent and disturbing nightmares that are among the most distressing symptoms of the disorder. A study of incarcerated men found that nearly three-quarters of inmates with PTSD who took an oral capsule of THC had their nightmares reduce or stop entirely. Reducing nightmares may be particularly important for improving the quality of life of people with PTSD, as better sleep can help to equip people to deal more effectively with other stressors, and may help them be more active in treatment, and with family and friends. In addition to improving sleep and decreasing nightmares, cannabis may help those with PTSD by more generally reducing anxiety and improving mood. However, regular cannabis use can also lead to withdrawal symptoms when cannabis use stops. Symptoms of cannabis withdrawal can include irritability, anxiety, and nightmares. Because symptoms such as these may already be problems for people with PTSD, starting and then stopping cannabis use might ultimately make PTSD worse rather than better. Helping people with PTSD who use cannabis manage their use and potential withdrawal is an important challenge that may play a big role in determining if and how cannabis medicines can be effective treatments for PTSD.

Active studies and the future of research on cannabis and PTSD

Clinical trials are an important method of establishing the effectiveness of a treatment, and completing such clinical trials will be necessary before cannabis can become a recognized treatment for PTSD. There are currently two clinical trials underway in Canada and the United States that, together, will include almost 200 participants with chronic, treatment-resistant PTSD. Both are double-blinded studies using a crossover design and different CBD/THC ratios of cannabis, including a placebo containing only a trace amount of THC. Neither the researchers nor the participants know what potency they are receiving. Both studies also have a six-month follow-up after the active participation has concluded. It is hoped that results from these trials will be available by 2020, if not sooner. Although these results may go a long way toward telling us how cannabis might be helpful for treating PTSD, information from other sources, such as following people with PTSD who use cannabis over the long term, and examining different types of cannabis—and different types of PTSD—will also be needed to help us understand how this complex plant might play a role in treating this complex disorder. Given the prevalence of PTSD, and the lack of effective treatment for many who suffer, such research is very much warranted, particularly in light of preliminary evidence that suggests that cannabis may help with some of the most troublesome symptoms of PTSD.

 
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Can psychedelic drugs treat PTSD?

by Matt Smith | WebMD

Jon Lubecky was running out of options when he checked into a small house-turned-clinic outside Charleston, SC.

The onetime Army artillery sergeant had been struggling with post-traumatic stress since he got home from Iraq, where his post had been shelled so often it was nicknamed “Mortaritaville.” In 2006, near the height of the insurgency and religious violence that followed the U.S. invasion, one of those shells sent shrapnel tearing through the outhouse where he was sitting in the middle of the night.

The shrapnel missed, but the shock of the blast knocked Lubecky out and left him with a traumatic brain injury. When he came home that fall, he found his wife had left him. He made the first of what would be five suicide attempts that Christmas.

“My life was a country song,” Lubecky says.

By the time he got to the clinic door in November 2014, doctors at a Veterans Affairs hospital had him taking half a dozen medications to treat his PTSD, and it wasn’t working. So Lubecky signed up for an experimental treatment he hoped would help: MDMA, a psychedelic drug commonly known as ecstasy or Molly -- a compound that’s been banned for decades.

“And that’s when everything went weird,” he says. “Good, but weird.”

After years underground, psychedelic drugs are getting attention as a potential treatment for depression and post traumatic stress disorder (PTSD).

MDMA, also known as ecstasy, has shown promise in studies of combat veterans. Psilocybin, the compound in “magic mushrooms” that gets you high, has been tested as a potential boost for people struggling to quit smoking. Researchers in Europe are conducting a survey of how “microdoses” of LSD or other drugs affect mental activity without altering perception. And the American Psychological Association held a symposium in early August on the potential uses of psychedelics.

“This is a very interesting, intriguing moment in psychiatric drug development,” says John Krystal, MD, chairman of the psychiatry department at the Yale University School of Medicine.

Lubecky was part of a trial conducted with the government’s blessing. He went to the house-turned-clinic three times, taking a dose of MDMA in combination with an extensive psychotherapy session. The drug is a form of amphetamine known for producing a sense of openness and emotional warmth, and Lubecky said it helped him discuss his experiences without producing the kind of intense physical responses of PTSD.

“The adrenaline kick didn’t happen. The hair didn’t stand up on my neck,” he says. “It’s like doing therapy while being hugged by everyone who loves you in a bathtub full of puppies licking your face.” The therapy sessions lasted up to six hours, “but it’s not traumatic at all.”

“There was no ‘A-ha’ moment,”
he says. “It was an incremental change over time, with jumps after each therapy session.”

Doctors have been reluctant to explore the potential uses of psychedelics since the 1960s, Krystal says. Not only did the federal government classify them as having no acceptable medical uses and a high potential for abuse, but many researchers believed they were too powerful to use therapeutically. "But the mental health field is facing “a moment of great need” that’s prompted some rethinking," he says.

“Our appreciation of the seriousness of psychiatric disorders is much more mature than it was then,” Krystal says. “We have a much better understanding about how common, how disabling -- and in some cases, with the rising suicide rate, how lethal these disorders are.”

Over the last 50 years, researchers have made “transformative” advances in understanding how the brain works. "But there haven’t been corresponding breakthroughs in psychiatric drugs," he says. And there have been some promising results so far.

A phase III clinical trial of the use of MDMA to treat PTSD is moving ahead after it won FDA designation as a potential “breakthrough therapy” last summer. That status holds out the prospect of speedy review by the agency and “catapulted” fundraising for the trial’s backers, says Brad Burge, spokesman for the California-based Multidisciplinary Association for Psychedelic Studies (MAPS).

“That breakthrough therapy designation communicates to funders and to the rest of the world that this is a very serious treatment and the FDA is taking it very seriously. That’s huge,” Burge says.

The new study is a follow-up to the one involving Lubecky and another 25 veterans, police and firefighters who took MDMA combined with psychotherapy. "After three doses in controlled settings, nearly all participants saw some improvement in their symptoms -- and about two-thirds “simply didn’t have PTSD anymore,” Burge said.

The results were published in May. Researchers checked in with participants 2 months after treatment, then a year later. "On average, those results actually kept getting better,” Burge says.

In Lubecky’s case, he says his PTSD symptoms are diminished by about 50% on the scale doctors use to assess the condition. Depressive symptoms are down 70%, and he no longer has suicidal thoughts. He’s now an advocate for MDMA therapy and works on veterans issues for MAPS, which he said “saved my life.”

“I was in such a place where I figured my stepson was going to be handed a folded flag off my casket at the age of 14,” he says.

“I know what an impact it’s had on my life,” he adds. “I have close friends of mine who are suffering right now. Anything I can do to grease the skids on that and the get the guys I served with, my guys, the help they need, I’ll do.”

“And now, I get to watch him grow up, drop him off at high school, watch him fall in love, watch him get his heart broke, watch him go to prom and go off to college … then when he’s old, and I’m really old, he’ll get the flag off my casket. And that’s the way it should be.”


There were no serious side effects, but the researchers did find one surprising result: Lower doses of MDMA were less helpful than not being given the drug.

“What we think might be happening there is it could be bringing up emotions or memories in people with PTSD without giving them the additional resources to deal with it in a productive way in therapy,” Burge says.

The FDA last month approved a study testing psilocybin to treat depression. British company COMPASS Pathways plans to begin the phase II trial immediately.

“Depression is the leading cause of ill-health and disability worldwide, and treatment-resistant depression affects more than 100 million people,” George Goldsmith, chairman of COMPASS Pathways, says in a statement. “It is a huge unmet need, and the trial will teach us more about how this new approach might address it."

Meanwhile, researchers at Johns Hopkins University have been studying the use of psilocybin to help people quit smoking. In follow-up interviews, 15 participants reported “a number of persisting positive effects beyond smoking cessation,” says Matthew Johnson, PhD, associate professor of psychiatry at Johns Hopkins.

“We found generally people claimed vivid insights into their self-identity in psilocybin sessions -- insights into the reasons they smoked,” he says. For most participants, withdrawal symptoms “really took a back seat to their fascination with their unfolding contemplation of these psychedelic sessions."

“I had one pilot participant who said, ‘It’s kind of like I’m in The Matrix and everything’s in slow motion. Here’s a craving that’s coming … instead of that sort of automatic response where my hand goes into my pocket, grabbing a cigarette and it ends up in my mouth, it’s more of a slow, deliberative mindful response.’”


Other participants described increased appreciation or a re-emergence of interest in music and art or poetry.

"Earlier research by Johnson and others at Johns Hopkins found psilocybin can produce 'clinically significant' improvements in depression and anxiety in patients with life-threatening cancer. The drug may be able to provide hope where conventional antidepressant drugs have had little effect," he says.

"But though imaging technology has given researchers the ability to view your brain on drugs, how psychedelic drugs work is still something of a mystery," Burge says.

“Even with MDMA, we have some strong theories about how it might be working to reduce PTSD symptoms in the long run, but we don’t know exactly why,” he says.

"More brain-imaging studies might help to determine the mechanism of action of these drugs," Burge says, "but they’re not needed to get federal approval of a treatment. The FDA only wants to know whether a drug is effective and that the benefits outweigh the risks."

Krystal, who also leads the clinical neuroscience division at the National Center for PTSD at the Department of Veterans Affairs, has warned that the lack of effective drugs to treat posttraumatic stress disorder is a “crisis.” Recent advances in neuroscience may provide a way to reopen the door for psychedelics or drugs like ketamine, which is also being tested as a treatment for depression, but he says that door should be pushed open cautiously.

“I think the central question at the moment is to determine exactly how much of the excitement over the potential therapeutic value of psychedelic drugs is hype and how much of it is real benefit,” Krystal says. “I’m afraid our current research base is so shallow that we have to approach these drugs in a very cautious and exploratory manner.”

https://www.webmd.com/mental-health/news/20180918/psychedlic-drugs-to-treat-depression-ptsd
 
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mr peabody

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Israel treating PTSD with MDMA

by Jonah Mandel | Medical Xpress | Aug 21 2019

Nachum Pachenick says he lived a nightmare for nearly two decades after being sexually abused and developing PTSD—until MDMA therapy came to his rescue.

"It's a life full of stress, pressure, nerves, anxiety, fatigue," the 46-year-old Israeli said from his home in Sde Boaz, a wildcat settlement in the occupied West Bank south of Jerusalem.

"You can't live like that."

Pachenick said relief came in 2014, when he took part in a clinical trial that included the use of MDMA, the active component in the drug known to nightclubbers as ecstasy.

The treatment's success on him and dozens of others has led Israel's health ministry to approve its own pilot for MDMA-assisted therapy for people with treatment-resistant PTSD.

Encouraged by trials so far, therapists involved hold out hope for its future treatment possibilities, though there have also been warnings that further investigation is needed.

Last year, a research team reported in the journal The Lancet Psychiatry that a trial in the United States showed positive results, but stressed such treatment should only be done hand-in-hand with psychotherapy under professional supervision.

During that trial, 85 "adverse events"—including anxiety, headaches, fatigue and insomnia—were reported by 20 participants. It was not clear however whether the MDMA or something else was responsible.

Pachenick had been part of the second phase of three trials conducted in a number of countries under the auspices of the Multidisciplinary Association for Psychedelic Studies.

MAPS hopes to receive approval from the US Food and Drug Administration for the process by 2021.

"The results of the trial's first two phases were extraordinary," said Dr Keren Tzarfaty, a psychologist in charge of training therapists for MAPS in Israel.

"When we look at these people a year after the end of their treatment, we see that 68 percent of the people who received MDMA-combined therapy don't have (PTSD) anymore or are not defined as having PTSD," she said.

"Recovery rates are especially impressive when taking into account the fact that the people who reach us have tried everything," Tzarfaty said from her spacious clinic in the Israeli town of Hod Hasharon.

"Their trauma is resistant to medication, to psychotherapy; they come to us as a last resort."

'Brought me home'

The third and final phase of the trials began in the second half of 2019, and demand far exceeded the mere 14 spots allotted for Israeli participants.

As a result, the Israeli medical establishment has decided to operate its own pilot programme and allow dozens more to receive the treatment, which is done in a controlled setting.

"The Israeli health ministry decided to take the humane and responsible measure to start a pilot of 50 people suffering from PTSD who are resistant to other forms of treatment," said Dr Bella Ben Gershon, in charge of trauma for the Israeli health ministry.

Tzarfaty has facilitated the training of 30 Israeli therapists to work with MDMA.

PTSD is triggered by experiencing an event so traumatic it cannot be fully processed, leaving parts of the brain in a state of hyperarousal and harming its elasticity.

"What MDMA has been found to do is "remove all the defences, but also create lots of compassion to others and oneself," Ben Gershon said.

"The drug can afford the joy and empathy those suffering from PTSD need to begin processing their trauma in the therapy sessions," Tzarfaty said.

The treatment includes 12-15 therapy sessions, all attended by both a male and female mental health professional.

Two or three of the sessions are under the influence of MDMA, administered in the form of a small pill.

While the PTSD of most Israelis taking part in the trial was caused by sexual assault, the country has also fought a series of conflicts, resulting in relatively high rates of the disorder, Ben Gershon said.

"Because of that, she believed the government had a moral duty to do what it could to help those suffering from it," Tzarfaty said.

Most Jewish Israelis must perform mandatory military service.

The current trials with MDMA, a substance created in a laboratory in 1912, are part of the "renaissance" in the research of psychedelic substances and their application in psychiatry over the past decade, Tzarfaty said.

Pachenick said the effects of the treatment on him were dramatic.

"The process put me back on track, but in a more profound way brought me home, to myself," he said.

"I'm a much calmer person today. I have a family that's very dear to me—all these things were very unstable beforehand."

 
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mr peabody

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MDMA may reawaken ‘critical period’ to help treat PTSD

Neuroscience News | April 4, 2019

MDMA, a psychedelic drug, has successfully been used to reopen the ‘critical period’ of learning the reward values of social behaviors. Researchers report, in mature mice given MDMA, oxytocin triggers signaling in synapses that help encode social learning and memory, a process that does not usually occur in older animals. The findings could help in the development of treatments for PTSD and other disorders.

Johns Hopkins neuroscientists have found that the psychedelic drug MDMA reopens a kind of window, called a “critical period,” when the brain is sensitive to learning the reward value of social behaviors. The findings, reported April 3 in Nature, may explain why MDMA may be helpful in treating people with post-traumatic stress disorder (PTSD).

Critical periods were first described in the 1930s in snow geese. About 24 hours after a gosling hatches, if mother goose is nowhere to be found, the hatchling will bond with an object, including non-living ones. Yet, if mother goose disappears 48 hours after her gosling hatches, the critical period is over, and the hatchling won’t bond to an object.

There is evidence for critical periods that smooth the way for development of language, touch and vision.

For the current study, neuroscientist Gül Dölen says, “We wanted to know if there was a critical period for learning social reward behaviors, and if so could we reopen it using MDMA, since this drug is well-known to have prosocial effects.”

Dölen studied groups of mice in enclosures with different bedding. They put several mice together in one enclosure with one type of bedding for 24 hours and, in the next 24 hours, put the same mice by themselves in another enclosure with a different type of bedding. The mice began to associate certain types of bedding with isolation or companionship. Then, they let the mice wander between enclosures with the two types of bedding and tracked how long the mice spent in each enclosure. The more time the mice spent in the bedding linked to their companions indicated more social reward learning.

“It’s why people gather around the water cooler,” says Dölen, assistant professor of neuroscience at the Johns Hopkins University School of Medicine. "People are conditioned to know that the water cooler is an optimal place to chitchat with companions."

In their experiments, Dölen and her colleagues found that the critical period for social reward learning in mice is around puberty and wanes once they become mature adults. To determine if they could reopen the critical period, the scientists gave MDMA to mature mice, waited 48 hours for the drug to be washed out of their system, and observed how the mice explored their enclosure and behaved with other mice in the enclosure. Following the treatment with MDMA, most of the animals responded to social interactions the same way as juveniles, by forming a positive association between social interactions and the bedding. This effect lasted for at least two weeks after the MDMA treatment, and it was not observed in mice given saline injections.

“This suggests that we’ve reopened a critical period in mice, giving them the ability to learn social reward behaviors at a time when they are less inclined to engage in these behaviors,” says Dölen.

Dölen and her postdoctoral student and first author of the current study, Romain Nardou, also observed that MDMA works to reopen the critical period only if the drug is given to mice when they are with other mice, not if it is given to mice while they are alone. "This suggests that reopening the critical period using MDMA may depend on whether the animals are in a social setting," say the scientists.

The mice maintained their ability to learn the rewards of social behavior for up to two weeks from the time they were given MDMA. During this time, Dölen and her colleagues also found that the brains of the mice had corresponding responses to oxytocin, known as the “love hormone,” which is made in the hypothalamus and acts in the brain as a signal between neurons that encode information about social rewards. They found these responses by looking more closely at synapses, the spaces between brain cells called neurons. Their experiments showed that, in mature mice given MDMA, oxytocin triggers signaling in the synapses that encodes learning and memory, which does not typically happen in mature mice.

Dölen says that opening the critical window for social reward behavior may also have implications for treating psychiatric conditions. A strong bond between a psychotherapist and patient is well-known to be important for successful treatment. If MDMA reopens the critical period for social reward learning in humans in the same way it does for mice, then it could explain why the drug has been successful in treating people with PTSD, perhaps by strengthening the psychotherapist-patient bond.

MDMA has been designated by the U.S. Food and Drug Administration as a “breakthrough therapy” for PTSD, meaning that the agency will fast-track the development and review of clinical trials to test it. However, the researchers caution that MDMA may not work for every psychiatric condition linked to social behaviors.

“As we develop new therapies or determine when to give these therapies, it’s critical to know the biological mechanism on which they act,” says Dölen.

 

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MDMA healed a first responder’s PTSD

Reality Sandwich | Sep 19 2019

As a first responder, Nick Watchorn had seen many terrible things in the course of his career. But the massive shooting of April 28, 1986 in Tanzania, Australia, completely shook his handle on reality. Now Nick is part of the experimental studies on therapeutic MDMA for PTSD treatment.

The Port Arthur Massacre, which occurred at a popular tourist site, left 35 dead and wounded 23 others. In terms of dealing with their own trauma, first responders were taught to “stay strong.” Equipped only with this attitude, Watchorn did not have any tools to emotionally process the event, and suffered thereafter from Post Traumatic Stress Disorder (PTSD).

Twenty years with PTSD

It wasn’t just the horror of the event. And, it wasn’t just the memories that haunted him, and woke him in the middle of the night with sweats and a racing heart. It had reshaped his entire worldview. After experiencing the worst side of humanity, he said he lost trust in people, knowing what they were capable of. Likewise, the inability to release an experience so wholly wrapped in fear made him terrified to try anything new. He lived in that fear and mistrust for 20 years, just trying to get by with alcohol, antidepressants, and reckless behavior. He also went to therapy, but his PTSD symptoms persisted.

Nick finally experienced relief from his PTSD while partaking in a Phase III clinical trial conducted by The Multidisciplinary Association for Psychedelic Studies (MAPS). MAPS spearheads research to study the possibilities of MDMA for PTSD sufferers, like Nick. Nick had 3 trials sessions. Taking an MDMA pill at the beginning of each, he then received psychotherapy treatment from Stephen Eric Sienknecht, Psy.D. While the effects of regular therapy sessions had dissipated within hours, these MDMA-induced sessions had lasting effects. Namely, he no longer feels PTSD symptoms. After 20 years, Nick feels free.

Street MDMA vs medical MDMA

MDMA is currently classified by the Drug Enforcement Agency (DEA) as a “Schedule I drug.” The substances that fall into this category are considered to have no medical use, and a high potential for abuse. Because of its illegality, MDMA consumers must buy it on the so-called black market. Accordingly, it is almost impossible to find the substance in pure form. Ecstasy found on the street can contain a variety of other substances, usually meant to keep one awake longer–like pain killers, caffeine, ketamine, or even amphetamines. Some of the pills don’t even contain any MDMA in them at all.

The point is – don’t think you can just call up your local drug dealer, order some “E” and resolve all of your traumas. Rather, the FDA has allowed MAPS to conduct clinical trials to administer MDMA in its pure form, which as we established, is hard to come by out there. Also, the subjects are not just sent on their merry way after taking the drugs, as they often are with legal prescription opioids and antidepressants. They must take the pills in the presence of psychotherapists. They stay with the patients throughout their entire “trip,” which can last 6-8 hours, or even overnight. The psychotherapists then prompt the patients to process their traumatic experiences in a new way. But how does that all work? Hold on, we’ll get there.

What is PTSD?

When most people hear PTSD, they think war veterans. That’s one group that has historically suffered from PTSD, without much success in alleviating their pain. And it’s easy to imagine, at least, how utterly overwhelming such an experience as war must be. There are different kinds of experiences however, war being one of them, that can trigger the brain to go into survival mode; that “fight or flight” thing your bio teacher always talked about. Its focus is to keep you alive – first. Thus, it puts the emotions aside for later. The emotions are usually too intense for the brain to process at one time anyway.

But the traumas that PTSD patients experience are so potent that they are difficult to process later, even 20 years later, as in Nick’s case. Instead, an emotional attachment to the memory continues to evolve, as well as a reiteration of fear. It becomes nearly impossible to control one’s thoughts, emotions, or physical symptoms. According to Nick’s psychotherapist, Psy.D Sienknecht, PTSD can even be life-threatening, or at the very least, completely debilitating.

MDMA for PTSD, why does it work?

MDMA basically does two things to the brain. First, it increases activity in the prefrontal cortex, which is responsible for creativity, planning, and critical thinking. It also decreases activity in the amygdala, which is responsible for fear response. Sienknecht describes this dual effect as a “window of tolerance.” In other words, the brain can re-experience the memory of traumas, but in a different way. A way that doesn’t cause re-traumatization by a fired amygdala.

MAPS published the results of Phase II clinical trials in a medical journal. In the Phase II trials, PTSD-affected subjects took MDMA and thereafter received psychotherapy treatment, just as Nick did. They revisited their traumatic memories, experiencing intense pain and anxiety, but with one key difference. They were able to remain emotionally engaged because of the MDMA. The study showed that 58% of participants no longer had PTSD after the trial, and 68% no longer had it a year later. This proof of effectiveness allowed the study to pass to Phase III, which Nick was a part of.

MAPS aims to prove that MDMA has medical and therapeutic benefits for patients with PTSD, like Nick. If they do, it may become the first Schedule I drug that the DEA reclassifies. There are other anxiety disorders, and medical conditions that psychedelics such as MDMA can potentially treat. MAPS, and other institutions around the world, recognize their power to heal trauma–in general. We await to see what other revelations MAPS, and organizations like them, will bring us, as they discover new ways of treating some of the biggest issues plaguing human beings today.

 
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Is ketamine a breakthrough medicine for PTSD?*

Doctors know ketamine as an intravenous anesthetic used most often on children and animals and abused as the party drug sometimes referred to as “Special K.” In the early 1990s, it became clear that slow infusions of ketamine at very low doses gave quick but brief relief to patients with severe depression.

Dr. Krystal noted evidence that ketamine may work especially quickly in people with bipolar depression and offers hope for others in need of new options: people who fail to respond to electroconvulsive therapy, people with a psychotic depression, people with severe anxiety or agitation as well as those with severe pain.

PTSD patients badly need a new solution, he explained: they only see about a 10% reduction beyond placebo with current anti-depressants. Combat-related symptoms are especially tough. The Department of Veteran Affairs funded two large trials of promising drugs, Prasozin and Risperidone, but they proved ineffective. "Moving forward," Dr. Krystal explains, "requires turning to 'a deeper understanding of the biology' underlying depression and PTSD."

Is glutamate the important neurotransmitter in depression and PTSD?

Current anti-depressants boost the availability of serotonin or serotonin and norepinephrine, two neurotransmitters that enable neurons in the brain to communicate. It has been proposed that depression involves a paucity of those neurotransmitters. Dr. Krystal, with his colleague Dennis Charney, M.D., also a member of the BBRF Scientific Council and Dean of the Icahn School of Medicine at Mount Sinai in New York, found evidence otherwise.

“He led a series of studies showing that depleting the body of serotonin, or depleting the body of norepinephrine, or [both], did not produce depression in people,” Dr. Krystal explains. “This suggested to us that maybe the biology of depression and stress-related disorders didn't primarily live in the primitive parts of the brain that use serotonin or norepinephrine to communicate, but rather in the higher centers of the brain, the cerebral cortex, where glutamate is the predominant neurotransmitter.”

Both PTSD and depression can be caused by stress. Releasing cortisol is part of the stress response, our reaction to danger. "Cortisol can be harmful if it's too much for too long, but it may also be harmful if it's too little for too brief a period,” Dr. Krystal said. "In unipolar depression, we get a continual bath of cortisol, which is abnormal. In people with PTSD, not enough cortisol may have been released at moments of extreme stress."

The result may be a loss of connection-points between neurons, called synapses. Dr. Krystal found evidence of this loss in a pioneering MRI brain scan study of PTSD patients published in 1995. “Nowadays, using functional MRI, we can show that functional connections in the brain are reduced in PTSD in relation to or correlated with the overall severity of PTSD, and symptoms such as numbing and hyper arousal,” he said.

In both PTSD and depression, the brain evidently fails to remodel the lost connections. But over months of treatment with anti-depressants, brain scans show regrowth of dendritic spines—connection terminals and key players in the metabolism of glutamate.

Ketamine is thought by some to block the N-methyl-D-aspartate (NMDA) receptor, which binds glutamate. The temporary block may jolt the brain to release glutamate, prompting a cascade of regrowth and reorganization. For some people, a single dose of ketamine can make depression disappear for several days, or for as long as two weeks.

“There's no ketamine in the body at the time when people are reporting the greatest clinical benefit,” Dr. Krystal points out. "The benefit is an after-effect, not yet understood scientifically."

"Dissociation—feeling detached from one’s own body—and occasional nausea, two side-effects of ketamine, are easily managed in a clinic, and we have not had cases of drug abuse,”
Dr. Krystal said, referring to carefully controlled experimental use of ketamine in clinical settings. A many as three-quarters of severe depression patients who have tried ketamine infusions have found some relief. Over time, many need less frequent infusions: 40 percent of Yale’s patients come for infusions once a month or less often. The long-term effectiveness and impact of ketamine remain unproven.

“This new neurobiology of PTSD and depression suggests that there may be other mechanisms for treatment that may come from this line of research,” Dr. Krystal concluded. He hopes to have results from the PTSD trial by early 2020.

 
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How to use psychedelic mushrooms as a tool to heal C-PTSD

by Ashley Michaud | Sociedelic | Sep 13 2019

People exposed to severe and continuing violence, abuse, neglect, and suffering may develop complex PTSD, a condition that surpasses conventional PTSD.

I am Ashley, I have a Masters in Health Coaching and attuned as a Reiki Master / Teacher, I am also certified in Integrative Nutrition, Hormone Health and a published Author. I don’t mention this to give myself authority but instead show you what is possible when you use psychedelics as a tool for Elemental Growth.

I started my life off a mess – using sex, ecstasy, alcohol and cocaine to cover up pain rooted in childhood abuse. I was taught to hold things in and that the stuff I wanted to talk about didn’t matter. I was shown that drinking, putting on a mask and SAD (Standard American Diet) foods were my only options in life and then I had my first dose of psychedelic mushrooms. I realized just how f***ed up and oppressed every culture is, I saw the big picture. I moved out of my moms at 14 years old, was kicked out of high school shortly after and had a rough few years learning about the world and who I am.

At 20 I began experiencing hormonal issues but continued to party, at this time I also decided to get an education. Because I liked to party and travel, I enrolled into College as a Hospitality and Tourism student. Wise at the time but I am still paying student loans off for this party phase of my life. After a few semesters I began to travel Canada accumulating new life experiences along the way. One day as I looked out at the Pacific Ocean, I heard a voice tell me “it’s time to get sober, and to do this you have to go home to the roots of where your trauma started.”

I did get sober shortly after my return. I cleaned up my diet too and truly did start healing my roots. I created a timeline of my life, I said goodbye to friends, family, items and thoughts that did nothing good for me. I also threw myself into 2 hours of Kundalini Yoga DVD’s by Maya Fiennes everyday and a weekend dose of psychedelic mushrooms.

I was doing the meditation thing, the clean eating thing but it was mushrooms that truly made the connections and guided me back to purpose and passion for life. It was the mushrooms that told me to start looking at my food in a new light – to think about life force energy and what I consume psychically, mentally and spiritually – even more why I am consuming it. For a year I tested every food in my local grocery store and bulk bin to see if it would grow. That’s how I got into Fluoride, GMO’s and our solutions “Permaculture” and Integrative Nutrition.

It was mushrooms that introduced me and ultimately the reason I became obsessed with Joe Rogan, Duncan Trussell and the McKenna Brothers. It was mushrooms that supported my sacred journey to sobriety, backpacking 3 countries in South America with no map or clue what I was doing and it was mushrooms that has helped me clear out my C-PTSD so I can fill my life up with laughter and good times with my son who gets the best of me everyday.

What is a biohacking?

Biohacking is all about self-improvement and human optimization. As Tony Robins explains it “biohacking is essentially the practice of changing our chemistry and physiology through science and self-experimentation to energize and enhance the body.” Now I don’t know if Tony practices with entheogens, but I know that they have helped me make the process of biohacking more focused and enjoyable.

Here’s my prescription or C-PTSD

My biohacking specialty is Moon Cycles, Circadian Rhythm, Seasonal Alignment, Positive Psychology & personized Alchemy. Most recently I have been microdosing psilocybin, written about in my book Be The Change: Your Guide to Elemental Growth Through Nature, Love, Food & Movement.

Top 3 elemental tips:

- Write an ongoing list of all the things you hate and title it “Things I Will No Longer Tolerate”
- Take action by recognizing your feelings as they come up and then eliminating the things that make you feel like sh**
- Reward yourself with new habits that align with who and where you want to be. Your dreams are only possible when you believe “it’s all happening”.

I am Ashley, and this is my blog on how I biohacked C-PTSD and my destructive behaviors using psychedelic mushrooms. I am the girl that has cleaned up her life, broken through family karma and tapped into her natural flow. Like me you have everything you need to heal yourself and reach each dream you put forth but you don’t have to do it alone. Having your own guide on the side lines can help you breakthrough roadblocks and unleash your true potential.

As a health coach I don’t fix my clients, they do that, my job is to ask the questions that will spark transformation – so here it is: What resonated with you most? How do you think this bio-hack will be of service to you rising to become the hero of your own story? Sending you good vibes & positivity on your Elemental Growth journey, it’s all happening!!

 
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