Defending MDMA [sassafras] as a Treatment for PTSD
The hypothesized mechanisms underlying the effectiveness of MDMA-assisted psychotherapy to treat PTSD are not based on its producing euphoria, but rather on its capacity to make confronting trauma-related thoughts, feelings, and memories more tolerable during therapeutic processing with support of a co-therapy team.
MDMA is a monoamine releaser, but unlike stimulants, it preferentially releases serotonin, followed by norepinephrine and dopamine.[1,2,3] This difference matters, because it fundamentally changes the nature of the drug’s effects. MDMA increases positive mood, but it also shares some effects with the classic psychedelics, such as changing the perceived meaning of thoughts and experiences.[4,5] Most important, MDMA increases empathy for the self and others and the tolerability of facing emotionally distressing memories or experiences, such as one’s “worst” memories or social rejection.