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An approach to treating post-traumatic stress disorder with MDMA emphasizes supervision from specially trained therapists. The news last week that the compound 3,4-methylenedioxymethamphetamine MDMA , popularly called ecstasy, alleviated post-traumatic stress disorder PTSD in a phase 3 trial was a milestone in efforts to turn psychedelic drugs into mainstream treatments. It also highlighted a therapeutic marriage that is getting increasing attention: providing a mind-altering drug while a patient receives care from a trained therapist. MAPS hopes to confirm the results in an ongoing second study and seek approval for the therapy from the U. The idea that psychedelic drugs and talk therapy work in synergy raises complex questions about how to optimize—and regulate—the drug experience. As MDMA and other tightly controlled psychedelic compounds inch closer to regulatory approval, careful supervision from therapists may help overcome their reputation as illicit substances and fears of indiscriminate use. That might allow trauma survivors who face intrusive flashbacks to reflect on disturbing memories with less fear and judgment. The psychotherapy the trial used looks different from the most thoroughly studied PTSD psychotherapies. Many of these direct a patient to confront painful memories. Yehuda, who has long worried that prolonged exposure therapy can retraumatize some patients and discourage them from continuing treatment, says the research offers a new direction. Others want to test MDMA alongside more mainstream talk therapies. Psychologist Anne Wagner of the mental health clinic Remedy is preparing to launch a pilot study that brings an approach called cognitive processing therapy into the pre-and post-MDMA sessions. Adding this more structured psychotherapy might improve results for some patients, she says. FDA declined to comment on how it might address supportive therapy in an approval. Uncertainty about the right talk therapy pairings extends to research on other psychedelic drugs. Albert Garcia-Romeu, a psychologist at Johns Hopkins University School of Medicine, is testing psilocybin-assisted addiction treatment. But in November , Oregon became the first state to legalize psilocybin for therapeutic use. It has appointed an advisory board to help make a plan for regulating the compound by December What type of psychotherapy experience should that be? And what qualifies a facilitator? By Meredith Wadman Jun. By Sofia Moutinho Jun. By Robert Service May. All rights Reserved. Got a tip? How to contact the news team. Science Insider.

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