Seminar Notes - Might MDMA be useful for psychotherapy?
Parrott (2007)
Review whether MDMA has the appropriate pharmacodynamic profile to be a therapeutic agent.
MDMA is a powerful central nervous system (CNS) stimulant which affects several neurotransmitter
systems and intensifies a range of psychobiological functions.
Can have acute positive mood effects.
However, potential anti-therapeutic characteristics.
Can intensify negative cognitions which may endure over time. (It can intensify both positive and
negative).
Setting, intention and expectancy are crucial for a positive outcome but these cannot be
guaranteed and they limit practical utility as it may be difficult to ensure there is appropriate
preparation abreactions may occur.
Post-MDMA there is a period of neurotransmitter recovery when low moods and negative
cognitions predominate, and these may exacerbate psychiatric distress.
Finally, diathesis– stress models suggest that psychiatric individuals are more prone to acute and
chronic abreactions to CNS stimulants such as MDMA. This is well established with other stimulants
but it has been noted it can occur with MDMA (*Greer & Tolbert, 1986).
The explanations proposed for MDMA-assisted therapy are all psychodynamic, and a
neurochemical model needs to be outlined. Neurochemical model would allow for the potential of
MDMA to be more clearly stated.
* Greer & Tolbert (1986)
MDMA was apparently physically safe for all 29 participants.
No side effects were serious and only one subject had a side effect for more than a week.
Vital signs revealed some increase in blood pressure and heart rate which would be safe in a
healthy person but not in anyone with vascular disease.
One participant experienced post-session psychological difficulties that were disabling for a few
days, likely to be as a result of him having previous anxiety few years earlier MDMA might
predispose people to a recurrence of previous psychological disabilities.
All 9 subjects with DSM diagnoses reported significant benefit, with two reporting lasting remission.
Relieved low self esteem and increased self acceptance and confidence.
Relief from back pain (targets psychosomatic components of physical disorders and not the
anatomic abnormality).
Parrott (2014)
Parrott (2007)
Review whether MDMA has the appropriate pharmacodynamic profile to be a therapeutic agent.
MDMA is a powerful central nervous system (CNS) stimulant which affects several neurotransmitter
systems and intensifies a range of psychobiological functions.
Can have acute positive mood effects.
However, potential anti-therapeutic characteristics.
Can intensify negative cognitions which may endure over time. (It can intensify both positive and
negative).
Setting, intention and expectancy are crucial for a positive outcome but these cannot be
guaranteed and they limit practical utility as it may be difficult to ensure there is appropriate
preparation abreactions may occur.
Post-MDMA there is a period of neurotransmitter recovery when low moods and negative
cognitions predominate, and these may exacerbate psychiatric distress.
Finally, diathesis– stress models suggest that psychiatric individuals are more prone to acute and
chronic abreactions to CNS stimulants such as MDMA. This is well established with other stimulants
but it has been noted it can occur with MDMA (*Greer & Tolbert, 1986).
The explanations proposed for MDMA-assisted therapy are all psychodynamic, and a
neurochemical model needs to be outlined. Neurochemical model would allow for the potential of
MDMA to be more clearly stated.
* Greer & Tolbert (1986)
MDMA was apparently physically safe for all 29 participants.
No side effects were serious and only one subject had a side effect for more than a week.
Vital signs revealed some increase in blood pressure and heart rate which would be safe in a
healthy person but not in anyone with vascular disease.
One participant experienced post-session psychological difficulties that were disabling for a few
days, likely to be as a result of him having previous anxiety few years earlier MDMA might
predispose people to a recurrence of previous psychological disabilities.
All 9 subjects with DSM diagnoses reported significant benefit, with two reporting lasting remission.
Relieved low self esteem and increased self acceptance and confidence.
Relief from back pain (targets psychosomatic components of physical disorders and not the
anatomic abnormality).
Parrott (2014)
