A Brief Guide for Professionals

Disclaimer: If you are suffering from PTSD, do not attempt to treat yourself with
MDMA. Street MDMA is notoriously impure and may contain psychoactive
adulterants that can exacerbate PTSD symptoms. If you are interested in participating
in a MDMA-assisted therapy for PTSD trial, you should contact MAPS. This
document does not constitute medical advice.

Over nine million adults in the United States currently suffer from Post-Traumatic Stress
Disorder (PTSD), a debilitating medical condition that can significantly decrease quality
of life. Therapeutic approaches that incorporate 3,4-methylenedioxymethamphetamine
(MDMA) present a potentially groundbreaking approach to treating PTSD. The United
States Food and Drug Administration now considers MDMA a breakthrough therapy for
individuals with treatment-resistant PTSD. In the following sections, we will define PTSD
and outline the process and potential benefits of MDMA assisted therapy so that you
can better understand this cutting-edge therapeutic approach.

What is Post-Traumatic Stress Disorder (PTSD)?
PTSD develops as a response to traumatic experiences and presents a range of
symptoms. According to the National Institute of Mental Health [NIMH], a diagnosis of
PTSD requires the following:
 A “re-experiencing symptom,” such as flashbacks, nightmares, or intrusive
thoughts related to the traumatic event
 An “avoidance symptom, such as intentionally avoiding “places, events, or
objects” that are connected to the traumatic event or intentionally suppressing
emotional states or thoughts connected to the event
 A minimum of two “arousal and reactivity symptoms,” such as feeling
agitated, angry, and jumpy or having difficulty sleeping and resting
 And a minimum of two “cognition and mood symptoms,” such as memory
issues, negative thinking, feelings of guilt or shame, or experiencing a loss of
pleasure in previously enjoyable activities

Epidemiological research sponsored by the U.S. Department of Veteran Affairs has
calculated that over a lifetime, 3.6% of men and 9.7% of women in the United States will
suffer from PTSD. Traditional treatments for the disorder rely on older models of therapy
—specifically, exposure therapy (ET) and cognitive restructuring therapy (CRT). But
these approaches, especially ET, can be difficult for patients to tolerate and may require
years of therapy. MDMA-assisted therapy presents an alternative to these approaches
and may prove more effective for treating PTSD.

What is MDMA Therapy?
MDMA-assisted therapy is a therapeutic approach that combines the use of MDMA, a
potent psychoactive chemical, with traditional talk therapy that helps patients process
traumatic memories. It is an emerging research area that may revolutionize how PTSD
is treated. In this section, we will describe MDMA in terms of its effects and therapeutic
What is MDMA (3,4-methylenedioxymethamphetamine)?
MDMA (3,4-methylenedioxymethamphetamine) is a potent psychoactive stimulant that
is considered an empathogen-entactogen due to its ability to generate positive feelings
of connection and euphoria. Though the chemical is known by a wide variety of names
(e.g., Ecstasy, E, XTC, Molly), in therapeutic settings it is referred to as MDMA to help
distinguish it from street versions of the chemical, which are notoriously impure and
should not be consumed for therapeutic purposes.
The Erowid Center, a 501 nonprofit organization dedicated to providing accurate
information about psychoactive plants and chemicals, provides details about the effects
of MDMA. According to the Erowid Center, the effects of MDMA can include the
Positive effects: mild to extreme mood lift, euphoria; increased willingness to
communicate; increase in energy (stimulation); ego softening; decreased fear,
anxiety, and insecurities; feelings of comfort, belonging, and closeness to others;
feelings of love and empathy; and forgiveness of self and others.
Neutral effects: decreased appetite; visual distortion; rapid, involuntary eye
jiggling (nystagmus); mild visual hallucinations (uncommon); moderately
increased heart rate and blood pressure (increases with dose); restlessness,
nervousness, shivering.
Negative effects: inappropriate and/or unintended emotional bonding; anxiety or
paranoia (less common than opposite); agitation (less common than opposite);
tendency to say things you might feel uncomfortable about later; mild to extreme
jaw clenching (trisma), tongue and cheek chewing, and teeth grinding (bruxia).
As these effects lists indicate, MDMA is a powerful psychoactive chemical that should
be treated with a great deal of caution and respect. Used in a structured therapeutic
setting, however, MDMA may provide the same relief as years of traditional therapy.

What are the Stages of MDMA-assisted Therapy for PTSD?
In general, MDMA-assisted therapy for PTSD occurs in three stages:
1.Initial counseling sessions. These sessions serve to determine the
patients’ eligibility for MDMA-assisted therapy and to prepare them for the
experience. Identifying therapeutic goals and providing education about the
chemical and its effects occur during this stage.

2. MDMA sessions. Following the initial counseling, patients will consume
MDMA under the supervision of a licensed practitioner. During the sessions,
patients work to identify and process traumatic memories. A variety of
therapeutic modes are presently being investigated for this phase of the therapy.
In general, there are three sessions; however, many patients experience
significant improvement in their PTSD symptoms with as few as two sessions.
The MDMA sessions occur within a controlled environment that is designed to
facilitate healing from trauma.

3.Integration sessions. Following the MDMA sessions, patients will
continue to work with a therapist (for up to 12 months) to integrate their
experiences into their daily lives.
As indicated by these stages, MDMA therapy for PTSD is an involved, long-term
process that requires robust therapeutic support. Integration of the experience is
necessary for achieving long-term recovery from PTSD. Patients should never attempt
to treat themselves with MDMA.