Australia to allow MDMA-assisted therapy for PTSD

Australia has moved to recognise MDMA as a medicine for the treatment of post-traumatic stress disorder (PTSD).

From July 1, 2023, medicines containing MDMA can be prescribed by authorised psychiatrists to those experiencing PTSD. The change also allows medicines containing psilocybin (magic mushrooms) to be prescribed for people with treatment-resistant depression.¹

Here we explore the therapeutic benefits of MDMA in treating PTSD.

To read more about the therapeutic benefits of psilocybin, visit our article: Magic mushrooms as medicine.

MDMA and PTSD

MDMA (or 3,4-methylenedioxymethamphetamine) is an empathogen drug. This means it can increase feelings of:

• empathy and kindness
• social acceptance
• connection to others.²

MDMA was first manufactured in the early 1900s to help control bleeding.

It became more commonly used in the 1970s and early 1980s by some psychiatrists to help in the treatment of PTSD.3 Around this time MDMA also started being used as a recreational drug in the party/rave scene.⁴

PTSD affects around 5-10% of Australians at some point in their lives.^{5, 6}

People can develop PTSD after experiencing a traumatic event, making them fear for their life or safety, or for those around them.

Symptoms can include:

• ongoing flashbacks or distressing reminders of the event
• dreams or nightmares about the event and difficulty sleeping
• feelings of anger, guilt or shame
• increased use of alcohol and other drugs.⁷

Read more about PTSD.

Current research on MDMA and PTSD

Research into the use of MDMA as a therapeutic drug stopped in the mid-1980s when the USA made it illegal, despite protests from researchers and health professionals.

Clinical research picked up again with a study published in 2010, and after successful clinical trials showed huge improvements in PTSD symptoms. Then, in 2017 the US recognised MDMA as a breakthrough therapy.⁸

Clinical trials are now being run across 15 locations in the USA, two in Canada, and three in Israel.⁹

Follow-up research has found MDMA-assisted treatment effective in improving PTSD symptoms.³ At least one year later, 67% of participants surveyed no longer met the criteria for a PTSD diagnosis.³

The first clinical trial in Australia was announced in 2020, and a number of others have commenced and been completed since.

The results of clinical trials, extensive public consultation, an expert panel report, and advice from the Advisory Committee on Medicines Scheduling has led to the TGA deciding to reschedule MDMA.¹⁰

How does MDMA help PTSD?

It’s important to note that MDMA alone doesn’t treat PTSD, and research doesn’t suggest it’s a ‘cure’.

What MDMA does is help the process of psychotherapy.^{11, 12}

MDMA can assist psychotherapy by reducing defensiveness and anxiety, increasing relaxation and improving mood. It can also increase the bond between the therapist and patient.¹¹

This may enable someone to revisit traumatic memories and work through their emotions without being re-traumatised, or finding the associated anxiety or fear too overwhelming.¹¹

Because MDMA appears to reduce anxiety associated with recalling traumatic experiences, it can also help increase insight and memory. Negative memories may feel less confronting, allowing the therapist and patient to have sessions without the patient becoming overly anxious.¹¹

Is clinical MDMA different than recreational MDMA?

MDMA for clinical use is produced to a pharmaceutical standard like any other medication used to treat mental health. The purity and strength of the dose is known, and it is given in a controlled and safe setting by a trained health professional during a therapy session.¹³

On the other hand, illicit MDMA pills (also known as ecstasy), powders or crystals are not regulated, and the purity and strength are unknown.

And in many cases, these substances are sold as MDMA despite only having a small amount of MDMA in them, or none at all. Other drugs and ‘fillers’ are often used instead, making the effects more unpredictable and increasing the likelihood of negative reactions.¹³

How to access MDMA-assisted therapy for PTSD

From July 1, 2023, if a general practitioner (GP) thinks that MDMA-assisted therapy may be an appropriate treatment option, they can refer you to a psychiatrist who is an authorised prescriber.

But this will likely be a very small number of psychiatrists to begin with, and your GP might not know of available psychiatrists.

If you’re not able find a GP who can refer you, other options are:

• participate in a clinical trial. To see if there are any clinical trials recruiting, check this page here: Australian Clinical Trials | Australian Clinical Trials.
• contact Mind Medicine Australia for further information.

For more info on the regulation change and access requirements visit: Re-scheduling of psilocybin and MDMA in the Poisons Standard: questions and answers | Therapeutic Goods Administration (TGA)