Could adding the mood-altering drug ecstasy to psychotherapy help people in the military who've been diagnosed with post-traumatic stress disorder recover in just two weeks? Alan Peterson, PhD, professor of psychiatry and behavioral sciences at The University of Texas at San Antonio (UT San Antonio), thinks it could, and he's preparing a study to test that theory.
"We believe these medications will increase your neuroplasticity so that you can fully benefit from the therapy that you're pursuing," Peterson explained. He is the director of the STRONG STAR Consortium, a national research network focused on identifying the best prevention and treatment for psychological health issues affecting military members, veterans, and first responders.
"For the average service member who deploys to a combat zone, I would say there are hundreds of potentially traumatic events that they're exposed to," Peterson said. Around 17% of people who serve in active combat zones experience PTSD.
"If they don't get good treatment, many of them end up being medically boarded out of the service," he added. "They end up at the VA. And long-term, it's a significant risk for suicide as well."
Peterson's earlier research has found that a type of psychotherapy called Prolonged Exposure therapy (PE) is an effective treatment for people with combat-related PTSD. Still, he thinks it could be more effective and in a shorter period of time if combined with a drug called MDMA, also known, when used recreationally, as ecstasy or molly. MDMA can induce heightened introspection and empathy, and for about two weeks after taking it, it also seems to improve the brain's ability to rewire itself. That's neuroplasticity, which Peterson described as "your brain's ability to think, to process, to look at things differently—for your brain to have the ultimate flexibility in processing memories and trauma."
In Peterson's new study, his STRONG STAR team will work alongside collaborators from Emory University School of Medicine to take advantage of those two weeks of MDMA-induced neuroplasticity. One hundred active-duty military, guard, and reserve personnel who have been diagnosed with PTSD will start a two-week treatment program of daily PE after a single dose of MDMA. There will be two groups of participants, each getting different doses of MDMA and the same therapy.
Peterson believes combining MDMA and PE will lead to significantly better outcomes than either alone, and that the compressed time period will remove some of the barriers that keep people in the military from getting the care they need and deserve. That includes the stigma of needing to participate in psychotherapy for a prolonged period of time. "If there are treatments that are available where they can come in, have a really good outcome, they're fit for duty, then I think it's gonna reduce the stigma because people will be, 'I'll do that for two weeks,'" Peterson said.
This work is rewarding for Peterson, a retired Air Force clinical psychologist who deployed three times after 9/11. "We can take people that are really, really suffering and by the end of the treatment, when we follow up with them, the entire trajectories of their lives have been changed, right?" And if this combined PTSD treatment improves outcomes in the way Peterson suspects it might, it could ultimately change the way PTSD is treated for everyone.
Science & Medicine is a collaboration between TPR and The University of Texas Health Science Center at San Antonio, about how scientific discovery in San Antonio advances the way medicine is practiced everywhere.
