Psychedelic-assisted therapy
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21 August 2024Переглянуто: 215
Psychedelic-assisted therapy (PAT) is an approach that combines psychotherapy with the use of certain psychotropic substances, such as: MDMA, psilocybin, ketamine, ibogaine, etc. Due to their ability to temporarily increase the psychological plasticity these substances are called psychoplastogens. Another name for this group of substances is psychedelics.
Stages of PAT
Different substances and psychotherapeutic approaches can be used in PAT. But the stages of psychedelic-assisted therapy are generally similar, no matter what method of psychotherapy is used.
The first stage is preparation. This stage involves establishing a relationship between the therapist and the patient (client), discussing the goals and intentions of therapy, determining indications and contraindications for PAT, providing information about the substance and its effects, discussing any fears, and generally creating a safe and comfortable working environment.
Further, if there are no contraindications for PAT, at least one therapeutic session with the use of a particular substance takes place. The session is conducted in a controlled setting under the supervision of trained therapists who help the patient (client) process traumatic experiences.
The main stage of PAT is integration. This means reflection on the gained experience, processing and incorporating insights gained during the session into daily life, and developing strategies for changing behavior based on them. Integration may include individual or group psychotherapy sessions, journaling, creative expression, or other activities.
What are the benefits of MDMA-assisted therapy for PTSD?
MDMA-assisted therapy is a subtype of psychedelic-assisted therapy that uses the substance MDMA. The biological properties of MDMA facilitate the psychotherapeutic process and help in the awareness and processing of trauma in several ways:
- MDMA allows patients to remain emotionally engaged while re-examining traumatic experiences without experiencing excessive anxiety or other painful emotions.
- MDMA promotes a heightened state of understanding, empathy, love, and deep gratitude, which allows for the experience of safe attachment and facilitates cooperation with the therapist.
- MDMA facilitates seeing trauma as an event that is in the past and recognizing the support and safety that exists in the present.
Are there any contraindications to MDMA-assisted therapy?
In addition to the benefits, there are also risks of MDMA-assisted therapy. They are mostly related to the stimulating effect of MDMA on the body. In particular, it can increase heart rate and blood pressure. Therefore, the use of MDMA is contraindicated for people for whom high blood pressure is a danger. We are talking about people who have:
- Cardiovascular diseases or hypertension,
- Aneurysms,
- A history of stroke,
- Glaucoma.
MDMA can also be dangerous for people with bipolar disorder, psychotic spectrum disorders, and seizure disorders.
Does MDMA have side effects?
MDMA has several side effects that are also related to its stimulant action.
- Common: short-term memory loss, difficulty concentrating, jaw clenching, bruxism (teeth grinding), insomnia, lack of appetite, palpitations, hot and cold flashes, nausea, vomiting, dizziness, anorgasmia, fatigue, and depression for several days after taking the drug.
- Less common: anxiety, blurred vision, weakness, overheating (especially in case of physical activity without sufficient fluid intake).
- Rare: dizziness attacks in case of frequent use or high doses.
These effects are more likely to occur with high doses of MDMA. And when MDMA is abused in very high doses (more than 0.5 g at a time), mild to moderate signs of toxicity occur: confusion, hallucinations, tachycardia, and high blood pressure. Severe overdoses can lead to coma, cerebral edema, malignant hyperthermia, seizures, serotonin syndrome, and death.
MDMA therapy is carried out in a controlled clinical setting under medical supervision. A comprehensive examination at the beginning of therapy and monitoring of the patient's condition during the entire therapy process are important components of the PAT that allow controlling side effects and make MDMA-assisted therapy safer and more effective.
Why is MDMA-assisted therapy currently considered experimental?
On the one hand, MDMA-assisted therapy and other forms of PAT are not completely new. MDMA-assisted therapy is already permitted under expanded access programs in Israel, the United States, and Canada, medical practice with MDMA and psilocybin is authorized in Australia. In 2023, the second phase III clinical trial of MDMA-assisted therapy for PTSD was completed and is expected to be followed by widespread implementation of MDMA-assisted therapy in the US, and later in Canada and the EU.
On the other hand, the long-term effects of MDMA use are not fully understood. Although the short-term safety of MDMA under controlled conditions has been demonstrated in clinical trials, the potential for long-term adverse effects still needs to be studied.
For more information, please follow the links:
1. Experience of using psychedelic-assisted therapy in the treatment of PTSD in the US and Ukrainian military:
https://www.upra.org.ua/hitman
https://www.upra.org.ua/uk/post/balmforpsychesscarredbywar
2. More about MDMA-assisted therapy:
https://www.upra.org.ua/uk/post/mdma-therapy
3. Other scientific sources: