What if the solution to one of the most daunting  psychological conditions were a party drug?

Post-traumatic stress disorder, or PTSD, affects a huge portion of our population. And while the treatments we use today vary, at best they’re only about 50% effective.

But new research suggests that people diagnosed with PTSD can experience a lot of relief  from an unconventional medicine. And that medicine is MDMA. [Intro] People with PTSD often experience fear or stress, even when they’re not in danger. It can result from a range  of previous experiences, such as witnessing someone’s  death or a physical assault.

If you experience PTSD, you might be familiar with  symptoms like flashbacks, numbed emotional responses, and sleep problems. So this is one of those things that can influence every aspect of your life. But, despite its broad impact, researchers aren’t totally sure what’s going  on in your body to cause those symptoms.

One chemical that might hold  some answers is oxytocin. This is a molecule that regulates  your anxiety and memories. And rat studies suggest that  when you’ve got a lot of it, oxytocin mainly goes to the  emotional center of your brain, called the amygdala, and decreases your fear and anxiety.

That means having a lot of oxytocin is typically great because it keeps you calm. And a study published in  2021 found that PTSD patients had significantly less oxytocin  than people without the condition. The authors of that study suggested that this could be a source of their stress, although they acknowledged that  it’s tough to measure this stuff, so more research is needed.

Right now, we’re kind of in  a chicken-or-egg situation regarding the link between oxytocin and PTSD. People who have a particular  variety of oxytocin-related genes might be at higher risk for PTSD.  That predisposition is the egg. And trauma can kick the enzyme that  breaks down oxytocin into high gear.

The environmental factor is the chicken. But both of those things could  happen to the same person. Some people might be unlucky enough to have both the predisposition for low oxytocin and traumatic  experiences that set off PTSD.

And for people living with PTSD, studies show that current treatments, like selective serotonin reuptake inhibitors, only work about half of the time. Since PTSD is associated with low oxytocin levels, one potential solution is  to bump up your oxytocin. But you can’t just give someone a shot of oxytocin to get rid of their symptoms because oxytocin has a hard time  getting into the brain from outside.

It’s blocked by a group of cells  called the blood-brain barrier. And that’s where MDMA could help. MDMA stimulates your brain  cells to release more oxytocin.

So if you can’t give someone oxytocin, you can get them to make  their own using that drug. Clinical studies have found that MDMA, in combination with therapy, is an effective treatment for PTSD. And these were the most thorough tests we do.

They were placebo-controlled, so half of the participants got MDMA and the other half got a  pill that didn’t do anything. They were randomized, so no selection went into  who got MDMA and who didn’t. They were double-blind, so  neither the participants nor the researchers knew  who got MDMA during testing.

They were conducted in multiple testing sites, so the results could be more broadly  applicable to people in different places. And they were phase 3 clinical trials, so they’d already passed the basic research and first two rounds of human studies. After the trials, most of the participants who had been given MDMA weren’t even diagnosable as having PTSD anymore!

And several participants  who hadn’t been able to work due to their PTSD symptoms returned to work. Another study followed up with participants who had undergone a similar treatment three years after being given the drug. They found that the treatment  continued to be effective. . . . .

Like, not from repeated use, but rather long-lasting effects  from the original trials. In both of these studies, MDMA was combined with therapy. And therapy alone is helpful  for many people with PTSD, but became much more effective when  the drug was added to the equation.

The researchers think that MDMA is a helpful tool in combination with therapy because it primes your brain  for learning and change. See, when we’re young, our brains  are much more adaptable to taking   in new information and forging connections. That’s called the critical  period, because as we age, we get less adaptable and that window  of flexibility starts to close.

So that period of time is critical to set up your brain for all of  the things you do later in life. And a study in mice found that MDMA recalibrates sensitivity to  stuff in their environment by reopening that critical period. Mice whose critical period had  already closed were given MDMA, and then started learning  again like the younger mice that were still in their critical period.

Another study built on this research, and  while mice were in that adaptable state, they essentially went through exposure-therapy for a similar kind of learned fear that  someone with PTSD might experience. And those animals stopped  showing PTSD-like responses! They did more tests to figure  out which parts of the brain were involved in this treatment  effect, and lo and behold, the was more active after  mice were treated with MDMA.

So to put it all together, it seems that MDMA makes cells  in the amygdala more active and release more oxytocin, which increases your brain’s adaptability so that you can confront triggering  experiences in a calmer state. That makes it an incredible treatment  option for people living with PTSD. But if you don’t have PTSD and you take MDMA recreationally  with any regularity, it might have very different effects.

MDMA keeps other chemicals in your brain, like serotonin and dopamine, from being cleared away and recycled. The buildup of these chemicals can  become toxic and damage your neurons. So this stuff should only be used as  advised by a medical professional.

But when used appropriately and in  combination with traditional therapy, studies show that MDMA can have  incredible therapeutic effects for people diagnosed with PTSD. Not bad for a party drug. Thanks for watching this episode of SciShow!

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