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A new UCLA Health analysis suggests MDMA-assisted therapy could benefit military personnel dealing with trauma-related conditions beyond post-traumatic stress disorder by strengthening the therapeutic relationship and improving treatment outcomes.
The review paper, published in the journal Neurorehabilitation, examines how MDMA-assisted therapy might help service members who have sustained neurological injuries during training or combat, even without a PTSD diagnosis.
Walter Dunn, UCLA Health assistant clinical professor of psychiatry and U.S. Marine Corps veteran, authored the analysis. As a staff psychiatrist at the Veterans Affairs Greater Los Angeles Healthcare System, Dunn noted that young, healthy service members often struggle with the sudden transition from active duty to potential medical discharge.
The analysis emphasizes that service members facing neurological injuries often experience isolation, self-doubt, and emotional challenges that can impede their recovery process. These complications can arise regardless of whether the individual has received a PTSD diagnosis.
The review suggests that MDMA's ability to facilitate social connections and boost self-esteem, combined with its potential effects on neural plasticity, could create more favorable conditions for successful neurorehabilitation among military personnel.
"These are service members who are in peak physical condition, and they suddenly suffer a catastrophic injury, one that could dramatically change the course of their life," Dunn said. "MDMA-assisted therapy could be very helpful in this context."
The analysis indicates that MDMA doses between 75 milligrams and 125 milligrams could enhance the therapeutic alliance between patients and therapists through increased social reward processing. The drug might also address low self-esteem issues that lead to emotional dysfunction and poor coping strategies.
The research review highlights MDMA's potential impact on neuroplasticity and the brain's ability to adapt and change. While human studies remain limited, mouse studies referenced in the review demonstrated that MDMA reduced anxiety behavior, enhanced working memory, and improved social reward learning through neuroplastic mechanisms.
This analysis follows the U.S. Federal Drug Administration's August decision to reject an application for using MDMA-assisted therapy in PTSD treatment. The U.S. Drug Enforcement Agency currently classifies MDMA as a Schedule I narcotic, defining it as a drug with "no currently accepted medical use and a high potential for abuse."
Dunn served on the FDA's independent advisory board that reviewed the PTSD treatment application. Among board members, he was the only one to vote to recommend approval based on both safety and efficacy considerations.
Clinical trials examining MDMA-assisted therapy for PTSD patients have shown promising results, including improved treatment tolerance and reduced dropout rates. These findings, combined with studies in healthy populations, suggest the therapy could benefit service members undergoing neurorehabilitation for various conditions and injuries.
"By its very nature, military service involves exposure to stressful and adverse experiences," Dunn said. "It is an inherently dangerous profession. This reality highlights the critical need for a sustained commitment to developing new treatments to support those who serve in the armed forces."
