PMID- 30303861
OWN - NLM
STAT- MEDLINE
DCOM- 20190118
LR  - 20220408
IS  - 1533-712X (Electronic)
IS  - 0271-0749 (Linking)
VI  - 38
IP  - 6
DP  - 2018 Dec
TI  - Methylenedioxymethamphetamine (MDMA) in Psychiatry: Pros, Cons, and Suggestions.
PG  - 632-638
LID - 10.1097/JCP.0000000000000962 [doi]
AB  - BACKGROUND: For a number of mental health disorders, including posttraumatic 
      stress disorders (PTSD), there are not many available treatment options. 
      Recently, there has been renewed interest in the potential of 
      methylenedioxymethamphetamine (MDMA) to restore function for patients with these 
      disorders. The primary hypothesis is that MDMA, via prosocial effects, increases 
      the ability of patients to address the underlying psychopathology of the 
      disorder. However, the use of MDMA poses potential problems of neurotoxicity, in 
      addition to its own potential for misuse. METHODS: In this article, the proposed 
      potential of MDMA as an adjunct to psychotherapy for PTSD is evaluated. The 
      rationale for the use of MDMA and the positive results of studies that have 
      administered MDMA in the treatment of PTSD are provided (pros). A description of 
      potential adverse effects of treatment is also presented (cons). An overview of 
      MDMA pharmacology and pharmacokinetics and a description of potential adverse 
      effects of treatments are also presented. Methylenedioxymethamphetamine-produced 
      oxytocin release and decreased expression of fear conditioning as well as one of 
      the MDMA enantiomers (the n R- entaniomer) are suggested as potential mechanisms 
      for the beneficial effects of MDMA in PTSD (suggestions). RESULTS: There is some 
      evidence that MDMA facilitates recovery of PTSD. However, the significant adverse 
      effects of MDMA raise concern for its adoption as a pharmacotherapy. Alternative 
      potential treatments with less adverse effects and that are based on the 
      ubiquitous pharmacology of MDMA are presented. CONCLUSIONS: We suggest that 
      additional research investigating the basis for the putative beneficial effects 
      of MDMA might reveal an effective treatment with fewer adverse effects. 
      Suggestions of alternative treatments based on the behavioral pharmacology and 
      toxicology of MDMA and its enantiomers are presented.
FAU - Schenk, Susan
AU  - Schenk S
FAU - Newcombe, David
AU  - Newcombe D
AD  - Centre for Addiction Research, School of Population Health, University of 
      Auckland, Auckland, New Zealand.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - J Clin Psychopharmacol
JT  - Journal of clinical psychopharmacology
JID - 8109496
RN  - 0 (Neurotransmitter Agents)
RN  - KE1SEN21RM (N-Methyl-3,4-methylenedioxyamphetamine)
SB  - IM
MH  - Humans
MH  - N-Methyl-3,4-methylenedioxyamphetamine/adverse effects/*pharmacology
MH  - Neurotransmitter Agents/adverse effects/*pharmacology
MH  - Stress Disorders, Post-Traumatic/*drug therapy
EDAT- 2018/10/12 06:00
MHDA- 2019/01/19 06:00
CRDT- 2018/10/11 06:00
PHST- 2018/10/12 06:00 [pubmed]
PHST- 2019/01/19 06:00 [medline]
PHST- 2018/10/11 06:00 [entrez]
AID - 10.1097/JCP.0000000000000962 [doi]
PST - ppublish
SO  - J Clin Psychopharmacol. 2018 Dec;38(6):632-638. doi: 
      10.1097/JCP.0000000000000962.