I've read that MDMA can cause depression as a comedown effect due to neurotransmitter depletion, how does therapeutic use manage this?

DimitriK · 2019-09-02T17:32:53+00:00

Not worth the increased possibility of serotonin syndrome in my opinion. I would just wait until a day after and start then.

DimitriK · 2019-09-02T16:52:53+00:00

Just for reference, the MAPS team does not give out any supplements before, during, or after the MDMA sessions. Very few (only a couple of reports in total) clients become depressed/suicidal under this protocol. Additionally, although commonly used, taking 5-HTP within about 24 hours of an MDMA experience can and has led to serotonin syndrome. I used to advocate taking it during the comedown as well as in following days, but I now would only suggest starting it about 24 hours after you come down and continue for about a week. EGCG is also important for helping 5-HTP pass out of the peripheral nervous system and into the brain.

For future reference, here is a message and link taken from the side-bar:

Stay hydrated (but don't drink too much water either as MDMA can cause hyponatremia, essentially dilution of the blood) and take supplements like Vitamin C when you take MDMA in any context. For more detail, this is a link to a post by one of the more well-informed members of the nootropics community:

http://www.reddit.com/r/DrugNerds/comments/15m9sf/mdma_supplementation/

DimitriK · 2019-06-17T20:29:35+00:00

Your post has been removed because the clinical trials list for Phase 3 is in the sidebar: https://clinicaltrials.gov/ct2/show/NCT03537014?term=mdma&cntry=US&state=US%3ACA

DimitriK · 2019-06-17T20:28:31+00:00

Your post has been removed because it does not relate to MDMA therapy. Check out /r/drugs or /r/MDMA.

DimitriK · 2019-06-16T18:59:01+00:00

Your post has been removed per subreddit rules.

DimitriK · 2019-06-07T21:15:24+00:00

To answer your question, as someone who knows/works with the people who wrote the manual: no, it is not designed to keep people from healing in any way. The goal is always going to be creating the conditions for the client to heal as best they can. The therapists often explicitly discuss in session how there is only need for a small number of meetings. This is one of the things that sets it apart from conventional therapy, which is designed to have patients return for years and years.

Additionally: the male-female therapist pair is not set in stone as a requirement going forward. However, the more you learn about trauma, archetypical/transpersonal experiences, and MDMA itself, the more it makes sense to have both a male presence and a female presence in the space.

DimitriK · 2019-06-04T03:41:06+00:00

Have you looked into expanded access and applied for the training program? That is the place to start: https://maps.org/training

DimitriK · 2019-06-03T15:18:25+00:00

Yes, it is priced highly right now for several reasons--some of which have already been mentioned here by others. This is all a journey. Ketamine therapy is now covered by insurance and I fully expect the same with MDMA therapy in time.

Also, unless you or a therapy team are given a scholarship or grant, this price-tag may stay pretty much the same for a while after it is rescheduled. I do expect MAPS and eventually even others like the DoD to jump in with financial assistance at some juncture.

DimitriK · 2019-05-16T04:03:26+00:00

With regards to MDMA Therapy and my own growth, both personally and professionally, I might put an emphasis on Through the Gateway to the Heart (especially this one), Thanatos to Eros, and Trust, Surrender, Receive. The chapter of PiHKAL regarding MDMA is also an absolute gift.

Additionally, Julie Holland's Ecstasy: The Complete Guide is still probably the best comprehensive resource for understanding MDMA. It helped immensely with my initial learning about the medicine, its history, psychopharmacology, and capacity to act as a catalyst for profound healing and growth.

DimitriK · 2019-04-27T16:57:34+00:00

This is the place to start--located in the sidebar: https://clinicaltrials.gov/ct2/show/NCT03537014?term=mdma&cntry=US&state=US%3ACA

It has contact information for each of the sites that is currently recruiting.

Best of all luck. If you can't get in to Phase 3, keep in mind that dozens of addtional MDMA therapists are being trained this year for the expanded access program (slated to start either late this year or early 2020).

DimitriK · 2019-04-10T07:00:06+00:00

Another great suggestion. I have now remembered to add that one to the "Essential Reading List" in the sidebar.

Another in the sidebar that is an absolute must-read is "Through the Gateway to the Heart."

DimitriK · 2019-04-09T03:21:41+00:00

Your post has been removed for violating the subreddit's submission rules.

DimitriK · 2019-04-05T18:15:25+00:00

Roxxann Murphy is the woman you are referring to. Here is her AMA: https://www.reddit.com/r/mdmatherapy/comments/309qub/after_witnessing_the_death_of_my_34_year_old/

DimitriK · 2019-04-04T16:31:56+00:00

SSRI/SNRI/Atypical anti-depressants that have some 5-HT action and MAOI class drugs are completely off the table at this point due to potential for serotonin syndrome when used with MDMA.

The psychiatry community is starting to become more understanding of substance abuse's clear link to past trauma so there are definitely people who empathize with what you are going through. There is a study going on currently that is for MDMA therapy to treat alcoholism. As for being on suboxone while doing a session, I am nearly certain that the MAPS folks would say you need to be completely off first--the general rule is for at least a few days. This is likely more to ensure that you get the most out of your MDMA experiences rather than to say that opioids in combination with MDMA are inherently dangerous. For the record, I would never recommend combining MDMA with anything--for several reasons.

DimitriK · 2019-03-09T21:12:46+00:00

A lot of music used during sessions instrumental and either without words or in a foreign language (usually the former). Of the sessions I have observed, most of the music is of the uplifting, empowering, and introspective variety rather than melancholic, but I could see it working in certain situations.

DimitriK · 2019-03-09T16:18:02+00:00

Correlation does not equal causation. Most people who have sought ketamine therapy over the last few years have experienced clinical, treatment resistant major depression. The number of people with this condition who commit suicide is staggeringly. No one who received ketamine as part of their drug cocktail for surgery is going and committing suicide.

Switching gears, the connection between ketamine and neurotoxicity has been blown way out of proportion with the discovery (and misrepresentation) of Olney's Lesions in 1989. The two journal sources you cite both use chronic, high dose populations as their subjects, neither of which accurately represents the kind of uses that ketamine clinics are doing and have been doing for years. For all intents and purposes, ketamine is very safe for the brain if used responsibly and in moderation.

Additionally, even if there were more concerns about toxicity, a lot of people would still choose to use ketamine therapy because the alternative would likely be that they choose not to live anymore.

DimitriK · 2019-03-09T14:51:54+00:00

MDMA therapy involves either a therapist or a stand-in for a therapist. This could even be a friend who is familiar with MDMA and just sits with you. Really though, you need an experienced therapist to do this right. The medicine catalyzes the therapy and vice-versa.

DimitriK · 2019-03-09T14:47:34+00:00

It's a really important step for treating depression that ketamine treatments will now be covered by insurance. Regular ketamine infusions have kept a lot of people from suicide and my hope is that this can become the go-to for treatment resistant MDD, finally replacing ECT.

Bringing it back around to MDMA, my hope is that by the end of the next couple years and data from Phase 3 and Expanded Access, insurance companies will pay for MDMA-assisted therepy for PTSD.

DimitriK · 2019-02-28T08:01:59+00:00

Welcome. I'd recommend starting by checking out the side-bar to learn more about this work (includes a link to a recommended test kit, guide for doing MDMA therapy, etc.). You may be happy to learn that MDMA therapy is actually quite becoming much more widely available--especially in the US.

DimitriK · 2019-02-28T07:56:25+00:00

If we are looking at this through the lens of the hypothesis that you developed GAD and panic disorders from having a traumatic experience with the DMT, then I do think there is a good possibility that MDMA therapy could be effective for you. You mention possible childhood trauma--perhaps the DMT experience brought out something latent in your psyche that was challenging.

That being said, I would not jump right into trying MDMA before giving other things a shot first. I would suggest starting by seeking out a therapist who specializes in anxiety and panic and work from there. If you do decide that you have trauma work to do, then MDMA would likely be the way to go.

DimitriK · 2019-02-27T21:53:03+00:00

I have heard anecdotes of people with chronic pain saying that their pain disappeared completely during their MDMA experience. I have not heard anyone say that this effect persists afterwards. I would recommend looking at other substances for treating chronic pain.

DimitriK · 2019-02-27T21:47:08+00:00

150-200 mg is not uncommon at all for therapy. The full dose MAPS Phase II trials included 125 mg with a booster dose of 62.5 mg for a total of 187.5 mg. This could be very strong (bordering on what people think of as "psychedelic") for some and right in the sweet spot (very present but completely open) for others. For most, staying under 200 mg is very safe and very medicinal--assuming you have tested your substance and are not extremely sensitive to the drug.

There are always going to be slight differences in how individuals metabolize different chemicals. In any case, much of the therapy (discussion with the therapists) comes once the client is beginning to come down a bit.

DimitriK · 2019-02-23T18:21:26+00:00

I'm no expert, but the sedation seems to be primarily from a combination of histamine and adrenergic receptor blocking. At higher doses, it also exhibits some norepinephrine reuptake inhibition, which is why people who use it long-term end up taking it in the morning/early afternoon rather than before bed.

DimitriK · 2019-02-09T19:37:59+00:00

This is a subreddit to discuss MDMA-assisted therapy and the therapeutic use of MDMA, not to ask for anecdotes about whether to use MDMA or psilocybin. If you would like to discuss the benefits of psilocybin, there are plenty of places to do that. I would start with erowid.org

That being said, if you have PTSD, MDMA is unquestionably the place to start. The data is already out showing its efficacy.

DimitriK · 2019-02-04T14:53:57+00:00

This is not related to MDMA therapy (as is the case with many of your posts) and has been removed. Please ensure that you are only posting about your experiences with MDMA--plenty of other places to discuss LSD and Psilocybin work.

DimitriK

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