1. ±3,4-Methylenedioxymethamphetamine: Treating PTSD in The Modern World
A Groundbreaking Methodology for Spiritual Wellness and Neuroplasticity
Ashley A. Baxter
Western Oregon University

2. Post-Traumatic Stress Disorder (PTSD)
DSM IV: “A stress and anxiety disorder following a traumatic event”
Flashbacks, hyperarousal, avoidance behaviors
1/13 Americans in the general population
1/7 returning veterans
Chronic PTSD: heightened, more severe form
1/5 survivors of interpersonal trauma (e.g. combat, assault)
Sertraline and Paroxetine
+ Extinction learning: repeated exposure to fear-evoking triggers, without harm

3. A Brief History of MDMA Use
U.S. government routinely experiment with psychedelics
1950s-1960s
First published case of recreational MDMA use
August, 1970
Nixon declares a “War on Drugs”
June, 1971
Alexander Shulgin procures a large following
September, 1976
Put on the federal list of Schedule I Drugs
March 13th, 1988
New powdered form, “Molly”, becomes widely popularized; small-scale studies on long-term effects
● Early 2000s

4. MDMA, “Ecstasy”, “Molly”
Synthetic psychoactive drug
Amphetamines and mescaline
“An easily controlled altered state of consciousness with emotional and sensual overtones.” – Nichols & Shulgin
Positive effects are psychological, while negative effects are predominantly physical:
Positives – sensory intensification, increased awareness, ego dissolution
Negatives – teeth grinding, restlessness, and loss of appetite
Closeness and affiliation

5. How Does the Individual Benefit?
Increase in positive brain activation
The role of oxytocin in bonding
Personal insight and development

6. 1. Positive Brain Activation
Entactogens: attach to 5-HT transporter, increases dopamine and noradrenaline
Euphoria
2 major regions of the brain:
Ventromedial prefrontal cortex (vmPFC) – decision making
Amygdala – emotions, “fight-or-flight”, memory
Emotional regulatory circuit (i.e. fear)
MDMA shuts down signaling for FEAR from the vmPFC, doesn’t get sent to amygdala – no fear!

7. 2. Oxytocin and Trust/Closeness
PTSD suffers experience feelings of isolation and avoidance behaviors
MDMA helps encode positive social memories through the release of oxytocin
Increased trust: comfortable sharing experiences
Increased insight, memory, and attention: detail recall
Effective treatment = established trust, social support
Success lies with an early, healthy establishment of trust between provider and patient

8. 3. Personal Insight and Development
MDMA increases access to emotionally upsetting events
Promotes memory reconsolidation
Three key areas:
Improves trust
Decreases avoidance, promotes pro- social behaviors
Increases recall and processing
Less, threatening; Lowered vmPFC = less fear, less threatening

9. Lasting change to the brain
Neuroplasticity
Lasting change to the brain
“Malleable”
5-HT is a transporter protein - excess serotonin levels
Epinephrine and noradrenaline
Brain-derived neurotrophic factor (BDNF)
A protein that promotes neuron growth and reinforcement
Stored in axons, is released into the preceding nerve’s dendrites
Strengthens nerve pathways
We are capable of strengthening and weakening pathways

10. Discussion Stakeholders Veterans
Rates of mTBI rapidly increasing due to modern warfare and IEDs
Suicide rates are double the general population
Survivors of interpersonal trauma (sexual, physical, etc.)
Medical providers
Taxpayers
Increased rates of treatment-resistant PTSD
BDNF build-up in the brain related to positive brain activity

11. Implications for the Future
Current Research:
1 MDMA-assisted psychotherapy can have benefits equivalent to 5 months of weekly therapy
Strengthen serotonergic and noradrenergic neurons; induced effects lasted after a 1 month follow-up
Minimal risk of self-administration or dependency
Removal from Schedule I
Veteran reintegration
Brain training with additional complementary/alternative methods

12. References
Amoroso, T. (2015). The Psychopharmacology of ±3,4 Methylenedioxymethamphetamine and its role in the treatment of posttraumatic stress disorder. Journal of Psychoactive Drugs; 47(5):
Erowid. (2015). MDMA timeline. The Vaults of Erowid. Retrieved from
Johansen, P. O. & Krebs, T. S. (2009). How could MDMA (ecstasy) help anxiety disorders? A neurobiological rationale. Journal of Psychopharmacology; 23(4):
Lanteri, C., Doucet, E. L., Hernandez Vallejo, S. J., Godeheu, C., Bobadilla, A. C., Salomon, L., et. al. (2014). Repeated exposure to MDMA triggers long-term plasticity of noradrenergic and serotonergic neurons. Molecular Psychiatry; 19:
Mithoefer, M. C., Wagner, M. T., Mithoefer, A. T., Jerome, L., Martin, S. F., Yazar-Klosinksi, B., et. al. (2013). Durability of improvement in post- traumatic stress disorder symptoms and absence of harmful effects or drug dependency after 3,4- methylenedioxymethamphetamineassisted psychotherapy: a prospective longterm follow-up study. Journal of Psychopharmacology; 27(1):
Oehen, P., Traber, R., Widmer, V., Shnyder, U. (2013). A randomized, controlled pilot study of MDMA (±3,4-Methylenedioxymethamphetamine) assisted psychotherapy for treatment of resistant, chronic Post-Traumatic Stress Disorder (PTSD). Journal of Psychopharmacology; 27(1):

13. Questions?
Commentary?