Therapeutic potential of psychedelic agents

Amphetamine, methylphenidate, morphine, heroin and ketamine are all drugs that can potentially be used clinically but, whenever we hear the word MDMA, the first thoughts that come to mind are of ecstasy, rave parties and people behaving in an odd manner and experiencing hallucinations, paranoia and disinhibition. Recently, there has been a lot of discussion on the use of MDMA for treatment-resistant post-traumatic stress disorder (PTSD), a psychiatric illness that is very difficult to treat and getting common these days because of all the horrific stuff happening around us. Mithoefer et al ^1,2 found that 83% of participants receiving MDMA-assisted psychotherapy in a pilot study no longer met the criteria for PTSD, and every patient who received a placebo and then went on to receive MDMA-assisted psychotherapy experienced significant and lasting improvements. We are still in the initial stages, and only a few studies have been done, but the results of these studies are very significant. More research in this area is needed and government needs to contribute by moving MDMA to the list of Schedule 2 drugs so that more research can be done. At the same time, one has to be very careful and vigilant to make these drugs legal for therapeutic use, looking into dependence risk, effects on memory, depression and chances of psychosis. More research is needed especially into possible harms of the drug. It will place more responsibility on clinicians to prescribe and monitor drugs like this. Making these drugs legal is not easy but has happened in the past; otherwise, people with terminal cancer would still be suffering with pain and agony in last days of their life, and people with attention-deficit hyperactivity disorder would be suffering despite being capable of doing everything. Legalising MDMA for therapeutic use is going to be beneficial not only for patients but also for the economy, looking at the resources we use for treatment-resistant PTSD.