Ben Sessa1, Jacob S Aday2,3,4, Steve O'Brien1, H Valerie Curran5,6, Fiona Measham7, Laurie Higbed1, David J Nutt1,4. 1. Centre for Neuropsychopharmacology, Imperial College London, London, UK. 2. Department of Psychology, Central Michigan University, Mount Pleasant, MI, USA. 3. Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA. 4. DrugScience, London, UK. 5. Research Department of Clinical, Educational & Health Psychology, University College London, London, UK. 6. National Institute for Health Research University College London Hospitals Biomedical Research Centre, London, UK. 7. Department of Sociology, Social Policy and Criminology, University of Liverpool, Liverpool, UK.
Abstract
BACKGROUND: Incorporating 3,4-methylenedioxymethamphetamine (MDMA) as an adjunct to psychotherapy has shown promise in recent years for treating various mental health conditions, particularly those involving trauma. However, concerns about declines in mood and cognition during the days following dosing, also known as 'Blue Mondays', have been raised as limitations to its clinical use. Although these changes have been well-documented among recreational users, there are critical confounds to these reports that limit generalizability to clinically administered MDMA. AIMS: Here, we aimed to evaluate the evidence basis for the negative side effects associated with MDMA as well as inform our understanding of the drug's post-acute effects in a clinical context with an open-label study. METHODS: The current open-label study examined MDMA therapy for alcohol use disorder (AUD; N = 14) and measured mood, sleep quality, illicit MDMA consumption and anecdotal reports after the acute drug effects had worn off. RESULTS: Participants maintained a positive mood during the week following drug administration in a clinical context. Relative to baseline, self-reported sleep quality improved at the 3- and 6-month follow-ups. Finally, no participants reported using or desiring to use illicit MDMA, and the anecdotal reports indicated that they perceived the treatment favourably. CONCLUSION: The results support the overall safety and tolerability of clinically administered MDMA and, importantly, suggest that the 'come downs' previously associated with the substance may be explained by confounds in research relating to the illicit sourcing of the drug and specific environmental setting for recreational consumption.
BACKGROUND: Incorporating 3,4-methylenedioxymethamphetamine (MDMA) as an adjunct to psychotherapy has shown promise in recent years for treating various mental health conditions, particularly those involving trauma. However, concerns about declines in mood and cognition during the days following dosing, also known as 'Blue Mondays', have been raised as limitations to its clinical use. Although these changes have been well-documented among recreational users, there are critical confounds to these reports that limit generalizability to clinically administered MDMA. AIMS: Here, we aimed to evaluate the evidence basis for the negative side effects associated with MDMA as well as inform our understanding of the drug's post-acute effects in a clinical context with an open-label study. METHODS: The current open-label study examined MDMA therapy for alcohol use disorder (AUD; N = 14) and measured mood, sleep quality, illicit MDMA consumption and anecdotal reports after the acute drug effects had worn off. RESULTS: Participants maintained a positive mood during the week following drug administration in a clinical context. Relative to baseline, self-reported sleep quality improved at the 3- and 6-month follow-ups. Finally, no participants reported using or desiring to use illicit MDMA, and the anecdotal reports indicated that they perceived the treatment favourably. CONCLUSION: The results support the overall safety and tolerability of clinically administered MDMA and, importantly, suggest that the 'come downs' previously associated with the substance may be explained by confounds in research relating to the illicit sourcing of the drug and specific environmental setting for recreational consumption.
Entities:
Keywords:
Blue Mondays; MDMA; alcohol use disorder; come downs; ecstasy; psychotherapy
Authors: Joost J Breeksema; Bouwe W Kuin; Jeanine Kamphuis; Wim van den Brink; Eric Vermetten; Robert A Schoevers Journal: J Psychopharmacol Date: 2022-08-26 Impact factor: 4.562