FDA advisors voted against MDMA therapy – researchers are still fighting for it ( www.bbc.com )

Some 13 million Americans struggle with post-traumatic stress disorder (PTSD). Existing therapies only bring relief for a fraction of patients, and new treatments are sorely needed, according to psychiatrists wrestling with the scale of the problem. So, there was distinct disappointment when an advisory committee at the US Food and Drug Administration (FDA) voted earlier this month against a therapy that many had hoped could offer the first new treatment for PTSD in 25 years.

A number of experts who study psychedelics have since spoken out in support of MDMA-assisted therapy for PTSD and have sharply criticised the recommendations of the FDA's Psychopharmacological Drugs Advisory Committee. But some are still optimistic that the treatment might be approved when the FDA delivers its final decision in August.

Ahead of the meeting, FDA approval of MDMA-assisted therapy for PTSD seemed likely, says Sandeep Nayak, an assistant professor of psychiatry at Johns Hopkins University, who investigates psychedelics as treatments for substance use and mood disorders. About two-thirds of people who received three sessions of MDMA and talk therapy no longer qualified for a PTSD diagnosis at the end of two Phase 3 clinical trials.

It's an outcome that is "almost double that of existing medications", says Gül Dölen, a neuroscientist at the University of California, Berkeley, who researches the mechanisms of how psychedelics achieve therapeutic effects. "What's more, [the treatment] led to durable improvements in these patients lasting at least six months."

treefrog ,

I would love to know how many members of this board have stock portfolios in pharmaceutical companies that are currently collecting huge amounts of money from antidepressants being used to treat people with PTSD.

Antidepressants that really aren't effective in the treatment of PTSD but make the pharmaceutical industry a shitload of money.

Like most things, when we follow the money we learn why powerful people make the decisions they do. And I imagine this instance is no different.

aniki ,

The government doesn't work for us. The war on drugs continues.

Varyk ,

Psilocybin.

Let them use psilocybin, which more effectively treats the same symptoms of PTSD for a longer time with simpler therapy schedules and no physiological risks or side effects, and let the researchers pursue MDMA as long as they want until they can figure out an effective therapy that isn't dangerous.

Fondots ,

As a child on a taco commercial once said

¿Por qué no los dos?

Both show promise though need further research to determine how they should be used most effectively and safely, they have similar legal hurdles, and different patients may respond better to one, the other, or possibly even a combination of both,

Varyk ,

As I said, there's no reason why not two.

Similarly, there's no reason to make people wait for a potential mdma medication while psilocybin is available, effective against the exact same symptoms, perfectly safe and has a simpler therapy regimen.

girlfreddy OP ,
@girlfreddy@lemmy.ca avatar

Because not everyone is exactly the same. Different experiences, different histories, different types of injuries/traumas means different methods of treatment.

Yes psilocybin is good. But it may not be for everyone.

Varyk ,

Nobody argued everyone's the same.

All of the arguments that are put forth for using MDMA to treat PTSD symptoms already work for over 80% of patients using a single treatment of psilocybin that is already available.

Go ahead and research MDMA, but don't deny people an available, effective, safe and simple treatment while we wait for the development of experimental therapies.

treefrog ,

Again you're spouting statistics with no scientific evidence to support them. I remember that study you linked with the 80%. That rate was not for PTSD but other chronic mental health conditions being treated with psilocybin.

Your claims have no evidence to support them so please stop. Because you're not helping.

Varyk ,

It's fine if you didn't read or don't like that study.

Those symptoms resolved by psilocybin are the same as the PTSD symptoms that MDMA hopes to treat one day.

You not liking a particular medication doesn't make it less effective or safe for people.

You might want to check out the news recently though,, MDMA is specifically not being approved last weekend this week because a safe therapy has not been found, unlike with psilocybin.

Psilocybin is safe, simple and effective.

Controlled studies have born this out.

flamingarms ,

You do know the hope is not to treat symptoms but underlying disorders, right?

Varyk ,

That's close.

Ptsd is much more effectively treated when you deal with the symptoms and the disorder itself instead of just focusing on The disorder and ignoring the symptoms.

Luckily, psilocybin therapies work on both symptoms and disorders.

I mentioned symptoms specifically because MDMA therapies are specifically focused on the symptoms right now that psilocybin already effectively treats.

So you can take the effective and perfectly safe psilocybin therapy regimen to alleviate symptoms and the disorder itself while focusing on supplementing that treatment with more traditional therapies to dig deeper into the disorder.

treefrog ,

I love psilocybin. I used to grow them and still am fond of them and encourage others to explore them.

But it treating similar symptoms to PTSD is not the same as having an 80% success rate with actual PTSD, which is the claim you're making and not the claim your study is making.

PTSD is not anxiety or depression, even if it can present with similar symptoms. Nor is it substance use disorder. It's trauma and it requires safety and community to unpack.

Psilocybin is great at helping us develop a deeper relationship with ourselves and life generally. But the hormones released during an MDMA session better facilitate safety and connection.

Honestly I'm not trying to convince you in particular because we've had this conversation before and you're unwilling to reexamine your own conclusions. But I'll keep correcting the narrative for others who come along.

Varyk ,

I remember you had those blinders about MDMA.

It's easier for you to believe whatever it is you believe than to accept the scientific and therapeutic conclusions that disagree with your beliefs.

Ask for slanting the narrative. However you feel like it, yeah go for broke.

The numbers and consistent facts make it pretty easy for me to fix your mistakes anyway.

treefrog , (edited )

There's so much projection in your post it's ridiculous.

PTSD is not treatable with SSRIs. Depression is.

And the logic you are using is that because psilocybin works well for depression it will be great for PTSD.

We already know that's not the case when we look at other drugs used to treat depression and PTSD. Such as the SSRIs I just mentioned.

They're not the same disease and you are drawing false comparisons between the two. I have lived with CPTSD my entire life. I have tried multiple anxiety and depression treatments. And they didn't work that well, because I have PTSD and not anxiety or depression, those are simply symptoms. And I have taken psilocybin probably 50 times if not more. Because I enjoy it and it helps me clarify my relationship with myself. But it's not as good at helping me feel safe and connected to other human beings as MDMA is.

If MDMA therapy was available I would jump on it tomorrow because I know it would help me more.

I've been researching this stuff personally for over 30 years. Both through consumption and studying the pharmacology and scientific literature.

You seem to be like a first-year psychedelic therapist or something because I remember that class description that you linked, which you completely misinterpreted as well.

Does psilocybin have some potential in treating PTSD? Yes. Does the current scientific understanding suggest that it would be better than MDMA for this? No. In fact it suggests that MDMA is superior in treating PTSD. And psilocybin is superior for treating end of life anxiety and depression, assuming these symptoms aren't being caused by an underlying condition such as PTSD.

They are very different diseases. Even if the symptomology is similar, that doesn't mean the treatment is the same.

Varyk ,

You claim to identify external projection by critiquing your own misunderstandings and assumptions about others.

I'm glad you personally like Molly and find it helpful.

It doesn't change how effective and safe psilocybin is.

You can like Molly 20% or 100% or a million percent personally, but that doesn't have any bearing on how safe and effective other therapies are at treating the same symptoms.

treefrog ,

Again you conflate symptoms and disease.

I think that's all I need to point out for anybody following this conversation.

Varyk ,

I understand it's easier for you to pretend I said something different than I said, but make-believe is not as convincing as you think it is.

MDMA is not ready as a therapy yet.

It isn't effective yet against the symptoms or disorder, and it isn't safe yet.

https://www.technologyreview.com/2024/06/06/1093327/fda-advisors-just-said-no-to-the-use-of-mdma-as-a-therapy/amp/

You should do all the drugs you want, drugs are great, but you shouldn't tell people not to take effective and safe therapies because you personally enjoy a drug that may have benefits in the future.

Psilocybin is here.

It helps with these problems.

MDMA does not yet have an effective therapy regimen.

9 out of 11 FDA researchers say:

Hold your horses

treefrog ,

I'm not telling anyone not to take psilocybin. Don't put words in my mouth.

I'm questioning the bias in that FDA advisory board. A reasonable question considering decades of prohibition and that historically FDA advisory boards have owned stocks in pharmaceutical companies that stand to lose profits if MDMA is approved as a medication.

In other words, the 9 out of 11 statistic that you just cited is a statistic that I don't trust because these individuals have historically been biased and are not specialists in psychedelic medicine.

And your whole argument hinges on this idea that because we have a treatment that could be effective we should not look into more effective treatments. In which case, meditation works just fine for all of this and is much safer than any medication we can put in our body. So, should we not use any mental health medications? And put all of our research money just into meditation? After all it is safe and effective, and much safer than either of these drugs.

Varyk ,

Question and enjoy whatever you like.

Meditation is not much safer than psilocybin.

Magic mushrooms are twice as safe as coffee.

Just because MdmA doesn't work, it doesn't mean that you don't have to use any therapies at all that do work.

This is the problem with your approach and conclusions.

You're so devoted to your personal experience with MDMA that when MDMA has been rejected, your next question is so then there's nothing?

That is not the logical conclusion.

The treatment you prefer is not yet safe or effective.

That's fine. There is a safe and effective treatment already.

Whatever else you are reading into this conclusion is your own.

There's nothing wrong with having effective solutions that don't jive with your personal preferences.

girlfreddy OP ,
@girlfreddy@lemmy.ca avatar

One has to wonder how many drugs you may have ingested that would make you think saying the same thing over and over again, without verifiable scientific proof (that is not simply a copy-pasta of an article in a tech mag) somehow proves your point.

Varyk ,

You don't believe scientific articles or studies.

Convincing rebuttal.

girlfreddy OP ,
@girlfreddy@lemmy.ca avatar

You haven't posted any. Do that and I will read them.

Varyk ,

I've posted a few, this is a longer conversation than you might be assuming.

Which type of articles are you specifically looking for?

girlfreddy OP ,
@girlfreddy@lemmy.ca avatar

The ones that scientifically support your statements.

Varyk ,

I'm going to go ahead and let you scroll back to my earlier conversations on this topic if you don't have any specifics you're curious about.

It's all in the post history.

If you want something new or specific that wasn't covered, let me know.

girlfreddy OP ,
@girlfreddy@lemmy.ca avatar

You have exactly zero studies in any of your prior posts and you're telling me to go back and look anyway?

Either support what you say or sit down.

Varyk ,

I can't help you if you don't know how to scroll.

But that's not on me.

I'm sure there's some YouTube tutorial you could watch.

I support what I say. You apparently don't know what you're looking for.

girlfreddy OP ,
@girlfreddy@lemmy.ca avatar

You apparently don't understand what facts are or how to find them ... preferring to blame others for your own failures.

Varyk ,

If it makes you more comfortable to ascribe your ineptitude to others, I'm happy to help.

There's got to be a video tutorial somewhere out there that can teach you how to scroll, though.

Might be easier than you having to make all this stuff up.

girlfreddy OP ,
@girlfreddy@lemmy.ca avatar

Might be easier if you find proof for your statements.

Varyk ,

It was pretty easy the first time.

You999 ,

As much as I hate to say this, MDMA being used for treatment of mental illnesses might not be viable option because of it's negative effects. I do not know if short term severe depression and long term memory loss is worth a reduction in PTSD. Maybe as a last resort medication similar to how methamphetamine is prescribed for drug resistant ADHD.

quinkin ,

Make it legal for cluster headache treatment too.

Varyk ,

Oh man, a thousand and 10%.

I did a deep dive into cluster headaches and that jaw nerve disorder that drives a lot of people to suicide, I really hope they do what psilocybin trial to relieve people of that.

Trigeminal neuralgia.

Yes 100%, people who have tried geminal neuralgia or any nerve damage and cluster headaches should probably try magic mushrooms.

Physiologically safe, rewires your brain in good ways in every study so far and a thousand anecdotal stories, why not try it?

treefrog ,

Psilocybin is not more effective for treating PTSD.

It's great for anxiety depression, those are not PTSD.

And you and I have had this conversation before but you are still spouting the same nonsense.

Both are needed. And you are minimizing what the FDA is doing here and how it will hurt people with PTSD.

Varyk ,

There's no reason to use a second solution to the exact same symptoms that a safe, simple and effectively solution already resolves.

You can choose your own therapy, but it's silly to tell people not to take the available, simpler, more effective proven solution in hopes that in the future a different solution will be available that might be as effective as psilocybin already is for these symptoms.

Jimmyeatsausage ,

There is absolutely reason to pursue second, third, and fourth solutions to medical problems. There is 0 reason to assume that if treatment A is effective in 70% of patients and treatment B is effective in 70% that it's the same 70%.

Braindead take.

Varyk ,

I agree, especially if the 70% is a hypothetical future therapy that isn't ready to be applied yet.

Use the thing that already works while you try to develop a different therapy.

Helping people now with psilocybin doesn't mean you can't do research into molly and other methods simultaneously.

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