Randomized Placebo-controlled Study of MDMA-assisted Therapy in People With PTSD - Israel

MDMA-assisted Therapy in Twelve People With War and Terrorism-related Posttraumatic Stress Disorder (PTSD)

The goal of this clinical trial is to learn if MDMA-assisted therapy can treat PTSD in participants with PTSD. Researchers will compare two sessions of MDMA-assisted therapy with two sessions of low dose (active placebo) MDMA-assisted therapy to determine if MDMA-assisted therapy is safe and works to treat PTSD symptoms.

Participants will be randomly assigned to receive either the full dose of MDMA or low active placebo dose of MDMA during each of two experimental sessions. PTSD symptoms will be measured throughout the study.

This study will examine whether two six to eight-hour long sessions of 3,4-methylenedioxymethamphetamine (MDMA)-assisted therapy scheduled two to four weeks apart are safe, and whether combining a fully therapeutic dose of MDMA with psychotherapy, compared with a low ("active placebo") dose of MDMA, will reduce PTSD symptoms, with symptoms measured four times, once at baseline and again 2, 6, and 12 months after the second experimental session. People who received the active placebo dose of MDMA can then take part in an "open label" study continuation, with the participant receiving a fully active dose of MDMA on two more six to eight hour-long psychotherapy sessions. Open-label means that the participants and the researchers know that the participant will receive the fully active dose of MDMA. People who take part in the open label study continuation have their PTSD symptoms checked six and 12 months after the second open label MDMA-assisted session.

This study will look at MDMA-assisted therapy in 12 individuals aged 18 years or older, with PTSD symptoms not improving after trying at least one treatment. At least two-thirds of participants will have diagnosed PTSD arising from war or terrorism-related trauma. Eight of 12 participants will be assigned to receive the full dose of MDMA, and four will be assigned to receive a low or "active placebo" dose of MDMA during each of two experimental sessions. The fully active dose consists of an initial dose of 125 mg MDMA HCl and a supplemental dose of 62.5 mg given 2 to 2.5 hours later. The active placebo dose consists of an initial dose of 25 mg MDMA HCl and a supplemental dose of 12.5 mg.

The study will will include two sixty minute long introductory therapy sessions, two active placebo or fully active dose MDMA-assisted therapy sessions, a sixty to ninety minute long therapy session 24 hours after each experimental session, and one to two hour-long therapy sessions occurring weekly between the first and second experimental session, and between the second experimental session and the end of the study.

Inclusion Criteria:

• Diagnosis of Posttraumatic stress disorder still remaining after at least one treatment, with treatment including psychotherapy or pharmacotherapy. At least two-thirds of participants will have PTSD as a result of war and terrorism
• May meet criteria for a mood disorder.
• Must be at least 18 years old.
• Must be able to stop taking psychiatric medication from the start of the study until the two-month follow-up.
• May continue seeing an outside therapist during the study, but cannot increase the length or frequency of treatments.
• Must be able to follow all the rules and instructions relating to the experimental session, including restrictions on food and substance (alcohol and drug) consumption
• Must be willing to stay overnight in the clinic after each experimental session until the non-drug session occurring the next morning.
• Must be willing to be contacted by one of the researchers on a daily basis for a week after each experimental session.
• If a woman of childbearing potential, must have a negative pregnancy test and must agree to use an effective form of birth control.
• Must be able to speak and read Hebrew.

Exclusion Criteria:

• Cannot have history of or be diagnosed with psychotic disorder or bipolar affective disorder - 1.
• Cannot be diagnosed with dissociative identity disorder, an eating disorder with active purging, or borderline personality disorder.
• Cannot have evidence or history of significant hematological, endocrine, cerebrovascular, cardiovascular, coronary, pulmonary, renal, gastrointestinal, immunocompromising, or neurological disease, including seizure disorder. (People with hypothyroidism who are on adequate and stable thyroid replacement will not be excluded).
• Cannot have uncontrolled hypertension, peripheral vascular disease, hepatic disease (with or without abnormal liver enzymes), or history of hyponatremia or hyperthermia.
• Cannot weigh less than 50 or more than 105 kg.
• Cannot have used "Ecstasy" more than five times during lifetime or in the past six months.
• Cannot present a serious suicide risk or be likely to require hospitalization during the course of the study.
• Cannot require ongoing concomitant therapy with a psychotropic drug.
• Cannot meet DSM-IV criteria for substance abuse or dependence for any substance save caffeine or nicotine in the past 60 days.
• Unable to give adequate consent.