Historically dubbed the “love drug” for its ability to induce sensual feelings and pro-social behaviour, MDMA is now being researched for a number of social and emotional-based uses such as assisted couples therapy, the treatment of sexual disorders and autism-related social anxiety.
Commonly known as ecstasy or “Molly”, MDMA was used in social settings since the 70s and 80s before gaining wider popularity in the 90s as a “club drug”. The gradual increase in its use followed the ban of the similar but more potently psychedelic 3,4-methylenedioxy-amphetamine (MDA) in 1970.
First synthesised in 1912 in Germany, MDMA was initially known as “empathy” due to its ability to induce empathetic feelings and strongly emotional interactions.
Chemist and psychopharmacologist Alex Shulgin introduced the chemical to psychotherapists in the late 70s, who began experimenting with it as an assistive tool for psychotherapy. However, America’s Drug Enforcement Agency (DEA) placed an emergency ban on the substance in 1895 putting it into Schedule 1 of the Controlled Substances Act – much to the opposition of the therapists.
This move halted potential research into the chemical until the US Food and Drug Administration (FDA) approved a clinical trial investigating the efficacy of MDMA as an adjunct to psychotherapy and a treatment for pain in terminally ill patients in the 1990’s.
In 2017, leading research organisation the Multidisciplinary Association for Psychedelic Studies (MAPS), was granted Breakthrough Therapy Designation for MDMA-assisted therapy for PTSD.
Enhancing sexual experiences
In 2019 findings, published in The Journal of Sexual Medicine, revealed that MDMA was one of the most commonly used drugs for enhancing sex.
The University College London research and the 2019 Global Drug Survey found respondents noted that MDMA increased “emotionality/intimacy” as opposed to GHB which increased “sexual desire”. It also highlighted that people from the UK were the most likely to combine drugs such as MDMA with sex, compared with the US and other European countries, Australia and Canada.
However, a 2001 study revealed that more than 90 per cent of subjects reported “moderately to profoundly increased” desire and satisfaction from MDMA, and that “orgasm was delayed but perceived as more intense.”
MDMA and couples therapy
A study from November 2021 – Couple Therapy With MDMA—Proposed Pathways of Action – explores pathways in which MDMA may assist couple therapy.
“MDMA’s first identified potential as a therapeutic catalyst was for couple therapy,” write the authors, highlighting eight cross-therapeutic outcomes for MDMA-assisted couple therapy including: empathy; communication; perception of social connection/support; non-avoidance; openness; attachment/safety; bonding/social intimacy; and, relationship satisfaction.
The authors highlight reasons for its potential efficacy for couples therapy could be linked to decreased perceptions of social rejection and its ability to facilitate the perception of positive emotional expressions.
MDMA and female Hypoactive Sexual Desire Disorder
More recently, a first-of-its-kind study will be investigating MDMA-assisted psychotherapy for the treatment of female Hypoactive Sexual Desire Disorder (HSDD).
The disorder is characterised by low sexual desire and emotional distress not attributable to an existing medical condition or relationship issue – which affects 10 per cent of adult women and 14 per cent of premenopausal adult women. The condition is largely untreated by current medications on the market.
In 2021, Mind Cure Health launched a clinical research programme – the “Desire Project” – that will explore the use of MDMA-assisted psychotherapy as a treatment for HSDD. The company will explore how MDMA may ease fear factors for women – a factor which feeds into the development of many sexual-based disorders for women.
MDMA and social anxiety
MDMA is also being explored for the treatment of autism-related social anxiety. Social anxiety and impairments in social functioning are common indicators of autism. It has also been estimated that approximately 12 per cent of the US general population experience social anxiety.
Mind Medicine recently announced it is launching a programme to develop R(-)-MDMA for the treatment of social anxiety and functioning in diagnoses that include autism.
MDMA is a racemic of two enantiomers, R(-) and S(+) and preclinical data have suggest that R(-)-MDMA has the acute pro-social and emotional benefits of MDMA, while also demonstrating fewer signs of stimulant activity, neurotoxicity, hyperthermia and abuse liability.
MindMed chief medical officer, Daniel Karlin has said the company wants to offer new hope to millions of people living with social anxiety for meaningful connection.
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