Question 1

What's a common misconception about MDMA as a therapeutic intervention that you find yourself continually addressing?

Ben Sessa · Accepted Answer

That it is dangerous physically. It is in fact very safe physically; we know this from 25years of heavy recreational use of ecstasy with very low rates of morbidity and mortality. It is not 100% safe (what therapeutic intervention is?) but when used clinically risks can be reduced to an absolute minimum.
The media representation of ecstasy as a dangerous drug is often over-inflated.

Question 2

Do you see age restrictions being put in place if therapeutic MDMA is made available to the public?

Ben Sessa · Accepted Answer

Yes. It will likely be available only to adults 18-65 years old initially, until further research is done in older people and children.

Question 3

In terms of addiction - what substances is MDMA most suitable for as an intervention?

Ben Sessa · Accepted Answer

I think of MDMA as a non-specific adjunct to psychotherapy. So in theory it could be applied to any condition that we currently treat with psychotherapy - which is all mental disorders!
It appears to be particularly good for tackling long-standing trauma-based disorders. Most research to date has been in PTSD, but addictions and other anxiety-based disorders could also respond to MDMA therapy. We need to do more research with a broader range of psychiatric conditions.

Question 4

Based on what type of psychotherapy (CBT or else..) is MDMA being used?

Ben Sessa · Accepted Answer

Good question. The simple answer is: It is it's own type of psychotherapy!
It is not CBT, or psychodynmaic, or psychoanalytical, or MET, or EMDR, or CAT, or IPT or anything else.
It is a unique form of psychotherapy that is designed specifically for use with the drug.
Of course, there are elements of all those different psychological models in MDMA therapy, but no previous model is rigidly stuck to. We are in the process of writing formal manuals for MDMA therapy for a variety of conditions. The manual for MDMA-PTSD therapy is available on the MAPS website.

Question 5

Are there any studies about treating anxiety disorders or depression with mdma? And what are the results?

Ben Sessa · Accepted Answer

To date, most studies with MDMA have been done on PTSD - and there are no published studies using MDMA-assisted psychotherapy to treat depression. There is one study (Danforth) using MDMA to treat social anxiety disorder in adults with autism. The results were good.  Many cases of anxiety and depression are caused by trauma, which leads to a stuck-ness and rigidity. Psychedelic-assisted psychotherapy can help shift the rigid thinking and allow new possibilities of thinking to emerge that can aid healing. Psychedelics act as non-specific adjuncts to psychotherapy. That is, they can deepen and strengthen the effects of psychotherapy. So, in theory, any psychiatric disorder that responds to psychotherapy (which is all of them), can, in theory be enhanced by psychedelic-assisted psychotherapy.

Question 6

Are there any protocols for treating anxiety disorders/depression with mdma? If so, where can I check them?

Ben Sessa · Accepted Answer

So far, most research with MDMA-assisted psychotherapy has been done only on PTSD. The protocols are available on the MAPS website (www.maps.org). There have, to date as far as I know, been only two studies on other conditions: Alicia Danforth's study on social anxiety disorder in people with autism and our own Bristol study on alcoholism. I think Alicia's protocol is on the MAPS website. Our Bristol protocol is not in the public domain yet.
There have not been any studies on depression, so I have not seen a protocol for that condition yet.

Question 7

What are the prospects for permissions MDMA therapy in the world besides USA?

Ben Sessa · Accepted Answer

As part of their Phase 3 drug development of MDMA-assisted psychotherapy for the treatment of PTSD, the Multidisciplinary Association for Psychedelic Studies (MAPS) is working not only with the US medicines regulatory body (FDA), but also with the European body (EMA).
FDA approval is likely to be a bit quicker - hopefully by the end of 2022. But EMA approval will come soon after that.

Question 8

Where does one go or how does one get into your field of research and hopefully learn how to use it in practice?

Ben Sessa · Accepted Answer

Good question. Personally I think that people who want to work with complex cases of mental disorder - especially those involving severe trauma - ought to have some form of formal (non-psychedelic) clinical training first. This means they could train as a medical doctor, a nurse, a counselor, a psychotherapist, a social worker, a physiotherapist, an occupational therapist or some other allied medical profession. 
Psychedelic training should - in my opinion - then come later, once they have gained experience working with normal patients in a variety of settings.

Question 9

Do psychedelics work for anxiety and depression? How?

Ben Sessa · Accepted Answer

Psychedelics act as non-specific adjuncts to psychotherapy. That is, they can deepen and strengthen the effects of psychotherapy. So, in theory, any psychiatric disorder that responds to psychotherapy (which is all of them), can, in theory be enhanced by psychedelic-assisted psychotherapy. 
Many cases of anxiety and depression are caused by trauma, which leads to a stuck-ness and rigidity. Psychedelic-assisted psychotherapy can help shift the rigid thinking and allow new possibilities of thinking to emerge that can aid healing.

Question 10

Hello Ben, I am really interested in following trials and research into MDMA therapy, are there trials in Australia?

Ben Sessa · Accepted Answer

Hi. I'm not totally up to speed with developments in Australia. But I am speaking at a conference in Melbourne this later year on psychedelics and MDMA. (www.mindmedicineaustralia.org)
There is also a group called Prism in Australia that organize research. Look them up.

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