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Ecstasy ingredient touted as treatment for anxiety in autism

by  /  25 September 2018
Social support: Trained therapists observe a person with autism take a pill containing MDMA or placebo.

Cordelia Molloy / Science Source

This article was originally published 16 November 2016, based on preliminary data presented at the 2016 Society for Neuroscience annual meeting in San Diego, California. We have updated the article following publication of the study 8 September 2018 in Psychopharmacology1. Updates appear below in brackets.

The active ingredient in the drug popularly known as ecstasy eases social anxiety in people with autism, and the effects last months after the treatment’s end. Researchers presented the preliminary findings yesterday at the 2016 Society for Neuroscience annual meeting in San Diego.

The researchers caution that recreational ecstasy users are unlikely to see similar benefits, however, because street forms of the drug rarely contain the amounts of the ingredient used in the trial.

MDMA, or 3,4-Methylenedioxymethamphetamine, is a synthetic compound reputed to improve sociability, friendliness and extroversion. People with autism who have taken ecstasy recreationally report improvements in empathy, ease of communication and feeling at ease in their body. This clinical trial is the first rigorous test of these reports.

Researchers randomly assigned eight adults with autism to take a pill containing 75 to 125 milligrams of MDMA, and another four adults to take a placebo. The participants received the treatment during a day-long supervised session with two trained therapists. They got the same treatment and therapy again one month later. [Participants received weekly 60- to 90-minute therapy sessions without MDMA for three weeks following each treatment.]

Prior to the treatment, the participants met with the therapists three times to learn about its possible effects. They also became accustomed to the therapists and to the room specially prepared with soft lighting and minimal noise.

During the treatment session, the participants performed a variety of tasks, including writing in a journal, working with art supplies, listening to music, sitting quietly with their eyes closed and interacting with the therapists.

Exploring ecstasy:

The researchers measured social anxiety before, during and after the treatments, and again six months after the second treatment, using a questionnaire called the Leibowitz Social Anxiety Scale. The study was double-blind, meaning that neither the participants nor the researchers knew whether a participant received the drug or placebo. Researchers from two California-based nonprofit research organizations led the study.

At the end of the trial, the individuals who received MDMA showed much less social anxiety, on average, than those in the placebo group. Social anxiety scores dropped from about 90 to nearly 40 in the MDMA group, compared with nearly 60 in the placebo group. These average group scores remained roughly the same six months later, despite no additional treatment.

The two groups did not show significant differences in any other measures, including quality of life, stress, depression or a test of the ability to tell when another person is lying or being sarcastic. They also did not differ in their changes in blood pressure, heart rate or body temperature during treatment.

None of the participants experienced severe side effects. But those who received MDMA were slightly more likely than controls to report feeling fatigue, anxiety, difficulty concentrating, decreased appetite and other minor side effects during and seven days after the treatment sessions. [And one of the participants who received MDMA reported experiencing a severe headache one day after receiving the treatment.]

It’s unclear how the treatment could lead to lasting changes in social anxiety. MDMA is known to trigger the release of chemical messengers in the brain, including serotonin, norepinephrine and dopamine. It also boosts levels of the hormones oxytocin and vasopressin, both of which are altered in some people with autism and are under investigation as possible autism treatments.

Berra Yazar-Kloniski, a clinical research scientist who presented the findings, says her team has collected blood samples from the participants. She says her team would also like to measure whether the treatment alters blood levels of oxytocin, vasopressin or the stress hormone cortisol. In addition, the team plans a second trial involving a larger number of participants.

For more reports from the 2016 Society for Neuroscience annual meeting, please click here.

  1. Danforth A.L. et al. Psychopharmacology (Berl) Epub ahead of print (2018) PubMed

5 responses to “Ecstasy ingredient touted as treatment for anxiety in autism”

  1. Alycia Halladay says:

    MDMA is an established neurotoxin. There is no known safe dose – even “low” doses have been associated with toxicity in humans. It doesn’t just release neurotransmitters, it produces long lasting decreases in serotonergic neurons with aberrant regrowth and should be approached with EXTREME EXTREME caution.

    • Degenerate76 says:

      MDMA is a neurotoxin as established by one-sided studies that set out only to prove the potential for harm, with no regard for any potential benefits and no attempt to establish if there was a safe dose. Many of the most useful medications we have would have been ruled harmful by the same criteria.

      In opposition to this is the fact that millions of people have been using it on a regular basis for decades now, and few genuine cases of short or long-term damage caused by MDMA itself are known. It takes a really stupid overdose for MDMA itself to do harm. Those cases of “ecstacy deaths” you see reported in the news always turn out to be something else. Often it’s something dangerous like PMMA being sold as MDMA (so actually a consequence of prohibition, rather than than argument for it). Or it’s extreme heatstoke/dehydration etc caused by reckless use.

      The most famous MDMA “victim” in the UK was a teenage girl called Leah Betts. Photos of her dying in intensive care were plastered all over the front pages of the British tabloids about 20 years ago. Just one hitch, when the autopsy results came in it turned out that what actually killed her was “water intoxication” – swelling of the brain caused by excessive water consumption. She took one harmless pill, then panicked and drank 7 litres of water in a couple of hours, which would kill anyone. Of course, they didn’t print this correction – the vast majority of people who remember the case would say she was killed by MDMA.

  2. Geza Kiss says:

    Note that it says: “Social anxiety scores dropped from about 90 to nearly 40 in the MDMA group, compared with nearly 60 in the placebo group.” So it is not much better than placebo (90 to 40 vs. 90 to 60). Moreover, “those who received MDMA were slightly more likely than controls to report feeling fatigue, anxiety, difficulty concentrating, decreased appetite and other minor side effects”. Not sure if these can be called “minor” side effects. It is not worth using this dangerous drug.

    • Degenerate76 says:

      How you can consider yourself in a position to make such a judgement having not experienced the benefits yourself? Are you on the spectrum? I am, and 5 years ago I tried MDMA for myself. It absolutely changed my life. I went from being a virtual recluse to having an active social life which I greatly enjoy. As with this trial, I also found that the beneficial effects on my social functioning lasted long after the drug itself was out of my system. To give you some idea of the difference, my score on the Baron-Cohen AQ test has reduced from 39 to 30.

      This trial was framed as using MDMA to treat the social anxiety, ie relieving symptoms, but I think it goes further than that. It may actually have a direct effect on the causes of Autistic deficits. MDMA causes a rush of serotonin, and studies have shown Autistic brains to have lower Serotonin transporter levels:

      5 years down the line, my only regret is that I waited until I was 35 years old to try this wonderful drug.

  3. Karen Joy Payton says:

    Curious as to how this trial could be double-blind — after all, isn’t MDMA known for euphoria and “feeling high”? Or was the dose sufficiently low to reduce that effect?

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