Study Comparing Three Doses of MDMA Along With Psychotherapy in Veterans With Posttraumatic Stress Disorder

• ClinicalTrials.gov Identifier: NCT01211405
• Recruitment Status: Completed
• First Posted: September 29, 2010
• Last Update Posted: September 26, 2018
• Sponsor: Multidisciplinary Association for Psychedelic Studies
• Information provided by (Responsible Party): Multidisciplinary Association for Psychedelic Studies

Study Description

Brief Summary:

This study is designed to provide information on whether psychotherapy ("talk therapy") combined with the drug MDMA is safe and helpful for subjects with posttraumatic stress disorder (PTSD). The study will compare the effects of a low, a medium and a full dose of MDMA on symptoms of PTSD in 24 veterans, firefighters or police officers. MDMA dose will be assigned at random, and the investigators and the subject will not know the dose given. The researchers will also investigate depression symptoms. The researchers believe that the full dose of MDMA will produce a greater reduction in PTSD symptoms than the two lower doses.

Condition or disease	Intervention/treatment	Phase
Posttraumatic Stress Disorder	Drug: Low dose MDMA; Drug: Medium dose MDMA; Drug: Full dose MDMA; Behavioral: Psychotherapy	Phase 2

Detailed Description:

Posttraumatic stress disorder (PTSD) is a debilitating mental disorder, that can develop after service in the armed forces. Psychotherapy performed along with MDMA is an innovative form of therapy for posttraumatic stress disorder. This study will follow on the findings of an initial pilot study in a sample largely made up of people whose PTSD did not develop from serving in the military. This study will investigate whether MDMA-assisted psychotherapy is safe and efficacious in a sample of veterans and whether maintaining an effective double-blind can be better addressed by performing a dose comparison study.

This study is a randomized, double-blind, dose comparison study with an open-label cross-over segment that will assess the safety and efficacy of MDMA-assisted psychotherapy in veterans with chronic posttraumatic stress disorder. Twelve of 24 participants will receive the full dose of 125 mg, six will receive 75 mg and six will receive 30 mg (active placebo dose). An independent rater blind to condition will assess symptoms of PTSD and depression, general quality of life and posttraumatic growth prior to any psychotherapy sessions one month after the second experimental session.

After undergoing three 90-minute non-drug introductory psychotherapy sessions with a male/female co-therapist team, study participants will undergo two eight-hour long experimental sessions scheduled three to five weeks apart, during which they will randomly receive either 30, 75 or 125 mg MDMA on both occasions, followed by a supplemental dose of half the initial dose. Participants will undergo integrative psychotherapy in between each experimental session, including on the day after each session. Vital signs and psychological distress will be measured throughout each experimental session, and suicidality will be assessed throughout the course of the study. Spontaneously reported side effects will be collected on the day of each experimental session, and for six days afterward. PTSD symptoms, symptoms of depression, general psychological function, posttraumatic growth and quality of sleep will be assessed one month after the second experimental session, and the blind will be broken.

Participants who received 125 mg MDMA will continue to have a third experimental session, and they will be assessed two months after the third experimental session.

Participants who received 30 or 75 mg MDMA may take part in an open-label crossover segment that will follow nearly identical procedures, except that there will only be one introductory session prior to the first experimental session. There will be three experimental sessions. Symptoms of PTSD, depression and posttraumatic growth will be assessed at the start of the study. They will also be assessed one month after the second and two months after the third experimental session.

All participants will be assessed 12 months after their final experimental session. PTSD and depression symptoms and posttraumatic growth will be assessed, and participants will complete a questionnaire concerning the costs and benefits of being in the study.

Study Design

• Study Type: Interventional (Clinical Trial)
• Actual Enrollment: 26 participants
• Allocation: Randomized
• Intervention Model: Parallel Assignment
• Masking: Triple (Participant, Investigator, Outcomes Assessor)
• Primary Purpose: Treatment
• Official Title: Randomized, Triple-Blind, Phase 2 Pilot Study Comparing 3 Different Doses of MDMA in Conjunction With Manualized Psychotherapy in 24 Veterans, Firefighters and Police Officers With Chronic Posttraumatic Stress Disorder (PTSD)
• Study Start Date: October 2010
• Actual Primary Completion Date: October 2016
• Actual Study Completion Date: November 2016

Arms and Interventions

Arm	Intervention/treatment
Active Comparator: Low dose MDMA; Participants will receive 30 mg MDMA during each of two blinded experimental sessions.	Drug: Low dose MDMA; 30 mg MDMA administered p.o. once during each experimental session. Upon mutual agreement this maybe followed by a supplemental dose of 15 mg MDMA 1.5 to 2 hours later; Other Names: MDMA; (; +/-)-3,4-methylenedioxymethamphetamine;; methylenedioxymethamphetamine; Behavioral: Psychotherapy; Psychotherapy throughout main study
Active Comparator: Medium dose MDMA; Participants will receive 75 mg MDMA on each of two blinded experimental sessions	Drug: Medium dose MDMA; 75 mg MDMA adminis5tered p.o. once at start of an experimental session. Upon mutual agreement, may be followed 1.5 to 2 hours later by a supplemental dose of 37.5 mg; Other Names: MDMA;; (+/-)-3,4-methylenedioxymethamphetamine; methylenedioxymethamphetamine; Behavioral: Psychotherapy; Psychotherapy throughout main study
Experimental: Full dose MDMA; Participants will receive 125 mg MDMA during each of two blinded experimental sessions, followed by a third open label session.	Drug: Full dose MDMA; 125 mg MDMA administered p.o. at start of an experimental session. By mutual agreement, may be followed 1.5 to 2 hours later by a supplemental dose of 62.5 mg MDMA.; Other Names: MDMA;; (+/-)-3,4-methylenedioxymethamphetamine; methylenedioxymethamphetamine; Behavioral: Psychotherapy; Psychotherapy throughout main study

Outcome Measures

Primary Outcome Measures :

1. Clinician-Administered PTSD Scale (CAPS) [ Time Frame: Baseline ]
   Clinician-administered and scored assessment of posttraumatic stress disorder (PTSD) following diagnostic criteria found in DSM IV.It produces a global score, a dichotomous diagnostic scale, and subscales
2. Clinician-Administered PTSD Scale (CAPS) [ Time Frame: One mo after Experimental Session 2 ]
   Clinician-administered and scored assessment of posttraumatic stress disorder (PTSD) following diagnostic criteria found in DSM IV.It produces a global score, a dichotomous diagnostic scale, and subscales
3. Clinician-Administered PTSD Scale (CAPS) [ Time Frame: Two months after Experimental Session 3 ]
   Clinician-administered and scored assessment of posttraumatic stress disorder (PTSD) following diagnostic criteria found in DSM IV.It produces a global score, a dichotomous diagnostic scale, and subscales
4. Clinician-Administered PTSD Scale (CAPS) [ Time Frame: 12 month follow up ]
   Clinician-administered and scored assessment of posttraumatic stress disorder (PTSD) following diagnostic criteria found in DSM IV.It produces a global score, a dichotomous diagnostic scale, and subscales

Secondary Outcome Measures :

1. Global Assessment of Function (GAF) [ Time Frame: Baseline ]
   A single-item clinician-assessed measure of psychological function and well-being
2. BDI-II [ Time Frame: Baseline ]
   Self-report measure of depression symptoms
3. Posttraumatic Growth Inventory [ Time Frame: Baseline ]
   A self-report measure assessing potential benefits or reframing of traumatic event or events
4. Columbia Suicide Severity Rating Scale (C-SSRS) [ Time Frame: Every face to face visit, two of 7 phone contact days, 12 month follow up ]
   A clinician-administered and scored measure of suicidal ideation and behavior, consisting of series of questions and adaptive to responses to questions.
5. Body temperature [ Time Frame: Every 60-90 minutes throughout first 8-h experimental sessionm ]
   Body temperature assessed via tympanic thermometer
6. Global Assessment of Function (GAF) [ Time Frame: One month after Experimetnal Session 2 ]
   A single-item clinician-assessed measure of psychological function and well-being
7. Global Assessment of Function (GAF) [ Time Frame: Two months after Experimental Session 3 ]
   A single-item clinician-assessed measure of psychological function and well-being
8. Global Assessment of Function (GAF) [ Time Frame: 12 month follow up ]
   A single-item clinician-assessed measure of psychological function and well-being
9. BDI-II [ Time Frame: One month after Experimental Session 2 ]
   Self-report measure of depression symptoms
10. BDI-II [ Time Frame: Two months after Experimental Session 3 ]
    Self-report measure of depression symptoms
11. BDI-II [ Time Frame: 12 month follow up ]
    Self-report measure of depression symptoms
12. Posttraumatic Growth Inventory [ Time Frame: One month after Experimental Session 2 ]
    A self-report measure assessing potential benefits or reframing of traumatic event or events
13. Posttraumatic Growth Inventory [ Time Frame: Two months after Experimental Session 3 ]
    A self-report measure assessing potential benefits or reframing of traumatic event or events
14. Posttraumatic Growth Inventory [ Time Frame: 12 month follow up ]
    A self-report measure assessing potential benefits or reframing of traumatic event or events
15. Peak Body temperature [ Time Frame: Peak value from measurements made every 60-90 minutes throughout second 8-h experimental sessionm ]
    Body temperature assessed via tympanic thermometer
16. Peak Body temperature [ Time Frame: Peak value from measurements made every 60-90 minutes throughout third 8-h experimental sessionm ]
    Body temperature assessed via tympanic thermometer
17. Peak blood pressure (systolic) [ Time Frame: Peak value from measuremades made every 15-30 min throughout first eight-hour experimental session ]
    Measuring systolic blood pressure
18. Peak blood pressure (systolic) [ Time Frame: Peak value from measurements made every 15-30 min throughout second eight-hour experimental session ]
    Measuring systolic blood pressure
19. Peak blood pressure (systolic) [ Time Frame: Peak value from measurements made every 15-30 min throughout third eight-hour experimental session ]
    Measuring systolic blood pressure
20. Peak Pulse [ Time Frame: Peak value from measurements made every 15-30 min throughout first eight-hour experimental session ]
    Assessing heart rate via pulse
21. Peak Pulse [ Time Frame: Peak value from measurement made every 15-30 min throughout second eight-hour experimental session ]
    Assessing heart rate via pulse
22. Peak Pulse [ Time Frame: Peak value from measurements made every 15-30 min throughout third eight-hour experimental session ]
    Assessing heart rate via pulse
23. Columbia Suicide Severity Rating Scale (C-SSRS) [ Time Frame: Baseline ]
    A clinician-administered and scored measure of suicidal ideation and behavior, consisting of series of questions and adaptive to responses to questions.
24. Columbia Suicide Severity Rating Scale (C-SSRS) [ Time Frame: Session prior to first experimental session ]
    A clinician-administered and scored measure of suicidal ideation and behavior, consisting of series of questions and adaptive to responses to questions.
25. Columbia Suicide Severity Rating Scale (C-SSRS) [ Time Frame: Twice during first experimental session ]
    A clinician-administered and scored measure of suicidal ideation and behavior, consisting of series of questions and adaptive to responses to questions.
26. Columbia Suicide Severity Rating Scale (C-SSRS) [ Time Frame: Twice during second experimental session ]
    A clinician-administered and scored measure of suicidal ideation and behavior, consisting of series of questions and adaptive to responses to questions.
27. Columbia Suicide Severity Rating Scale (C-SSRS) [ Time Frame: Twice during third experimental session ]
    A clinician-administered and scored measure of suicidal ideation and behavior, consisting of series of questions and adaptive to responses to questions.
28. Columbia Suicide Severity Rating Scale (C-SSRS) [ Time Frame: 12 month follow up ]
    A clinician-administered and scored measure of suicidal ideation and behavior, consisting of series of questions and adaptive to responses to questions.
29. Columbia Suicide Severity Rating Scale (C-SSRS) [ Time Frame: First psychotherapy session after experimental session 1 ]
    A clinician-administered and scored measure of suicidal ideation and behavior, consisting of series of questions and adaptive to responses to questions.
30. Columbia Suicide Severity Rating Scale (C-SSRS) [ Time Frame: Second psychotherapy session after experimental session 1 ]
    A clinician-administered and scored measure of suicidal ideation and behavior, consisting of series of questions and adaptive to responses to questions.
31. Columbia Suicide Severity Rating Scale (C-SSRS) [ Time Frame: Third psychotherapy session after experimental session 1 ]
    A clinician-administered and scored measure of suicidal ideation and behavior, consisting of series of questions and adaptive to responses to questions.
32. Columbia Suicide Severity Rating Scale (C-SSRS) [ Time Frame: First psychotherapy session after experimental session 2 ]
    A clinician-administered and scored measure of suicidal ideation and behavior, consisting of series of questions and adaptive to responses to questions.
33. Columbia Suicide Severity Rating Scale (C-SSRS) [ Time Frame: Second psychotherapy session after experimental session 2 ]
    A clinician-administered and scored measure of suicidal ideation and behavior, consisting of series of questions and adaptive to responses to questions.
34. Columbia Suicide Severity Rating Scale (C-SSRS) [ Time Frame: Third psychotherapy session after experimental session 2 ]
    A clinician-administered and scored measure of suicidal ideation and behavior, consisting of series of questions and adaptive to responses to questions.
35. Columbia Suicide Severity Rating Scale (C-SSRS) [ Time Frame: First psychotherapy session after experimental session 3 ]
    A clinician-administered and scored measure of suicidal ideation and behavior, consisting of series of questions and adaptive to responses to questions.
36. Columbia Suicide Severity Rating Scale (C-SSRS) [ Time Frame: Second psychotherapy session after experimental session 3 ]
    A clinician-administered and scored measure of suicidal ideation and behavior, consisting of series of questions and adaptive to responses to questions.
37. Columbia Suicide Severity Rating Scale (C-SSRS) [ Time Frame: Third psychotherapy session after experimental session 3 ]
    A clinician-administered and scored measure of suicidal ideation and behavior, consisting of series of questions and adaptive to responses to questions.
38. Columbia Suicide Severity Rating Scale (C-SSRS) [ Time Frame: Phone contact days 2 and 7 after experimental session 1 ]
    A clinician-administered and scored measure of suicidal ideation and behavior, consisting of series of questions and adaptive to responses to questions.
39. Columbia Suicide Severity Rating Scale (C-SSRS) [ Time Frame: Phone contact days 2 and 7 after experimental session 2 ]
    A clinician-administered and scored measure of suicidal ideation and behavior, consisting of series of questions and adaptive to responses to questions.
40. Columbia Suicide Severity Rating Scale (C-SSRS) [ Time Frame: Phone contact days 2 and 7 after experimental session 3 ]
    A clinician-administered and scored measure of suicidal ideation and behavior, consisting of series of questions and adaptive to responses to questions.
41. Peak Subjective Units of Distress [ Time Frame: Peak value from measurements made every sixty-ninety minutes during experimental session 1 ]
    Single item assesses self-reported psychological distress
42. Peak Subjective Units of Distress [ Time Frame: Peak value from measurements made every sixty-ninety minutes during experimental session 2 ]
    Single item assesses self-reported psychological distress
43. Peak Subjective Units of Distress [ Time Frame: Peak value from measurements made every sixty-ninety minutes during experimental session 3 ]
    Single item assesses self-reported psychological distress
44. Pittsburgh Sleep Quality Index [ Time Frame: Baseline ]
    Self-report measure of sleep quality
45. Pittsburgh Sleep Quality Index [ Time Frame: One month after Experimental Session 2 ]
    Self-report measure of sleep quality
46. Pittsburgh Sleep Quality Index [ Time Frame: Two months after Experimental Session 3 ]
    Self-report measure of sleep quality
47. States of Consciousness Questionnaire [ Time Frame: After experimental session 1 ]
    Assesses subjective effects and experience of alterations in consciousness
48. States of Consciousness Questionnaire [ Time Frame: After experimental session 2 ]
    Assesses subjective effects and experience of alterations in consciousness
49. States of Consciousness Questionnaire [ Time Frame: After experimental session 3 ]
    Assesses subjective effects and experience of alterations in consciousness
50. Neuroticism Extroversion Openness Inventory (NEO) [ Time Frame: Baseline ]
    Self-report, Assesses five personality factors
51. Neuroticism Extroversion Openness Inventory (NEO) [ Time Frame: 1 months after Experimental Session 2 ]
    Self-report, Assesses five personality factors
52. Neuroticism Extroversion Openness Inventory (NEO) [ Time Frame: 12 months after Experimental Session 3 ]
    Self-report, Assesses five personality factors
53. Pre-drug body temperature [ Time Frame: Body temperature prior to drug administration during first experimental session ]
    Body temperature assessed via tympanic thermometer
54. Peak body temperature [ Time Frame: Peak value from measurements made every 60-90 nin during first experimental session ]
    Body temperature assessed via tympanic thermometer
55. Pre-drug body temperature [ Time Frame: Body temperature prior to drug administration during second experimental session ]
    Body temperature assessed via tympanic thermometer
56. Pre-drug body temperature [ Time Frame: Body temperature prior to drug administration during third experimental session ]
    Body temperature assessed via tympanic thermometer
57. Endpoint body temperature [ Time Frame: Body temperature 7 h +/-30 min post drug administration during first experimental session ]
    Body temperature assessed via tympanic thermometer
58. Endpoint body temperature [ Time Frame: Body temperature 7 h +/- 30 min post drug administration during second experimental session ]
    Body temperature assessed via tympanic thermometer
59. Endpoint body temperature [ Time Frame: Body temperature 7 h +/- 30 min post drug administration during third experimental session ]
    Body temperature assessed via tympanic thermometer
60. Pre-drug Pulse [ Time Frame: Pre-drug value at first eight-hour experimental session ]
    Assessing heart rate via pulse
61. Endpoint Pulse [ Time Frame: Pulse 7 h +/- 30 min post drug on first 8-hour experimental session ]
    Assessing heart rate via pulse
62. Pre-drug Pulse [ Time Frame: Pre-drug pulse on second eight-hour experimental session ]
    Assessing heart rate via pulse
63. Endpoint Pulse [ Time Frame: Pulse 7 h +/- 30 min post-drug on second eight-hour experimental session ]
    Assessing heart rate via pulse
64. Pre-drug Pulse [ Time Frame: Pre-drug pulse on the third eight-hour experimental session ]
    Assessing heart rate via pulse
65. Endpoint Pulse [ Time Frame: Pulse 7 h +/- 30 min post-drug on third eight-hour experimental session ]
    Assessing heart rate via pulse
66. Peak blood pressure (diastolic) [ Time Frame: Peak value from measuremades made every 15-30 min throughout first eight-hour experimental session ]
    Measuring diastolic blood pressure
67. Peak lood pressure (diastolic) [ Time Frame: Peak value from measurements made every 15-30 min throughout second eight-hour experimental session ]
    Measuring diastolic blood pressure
68. Peak blood pressure (diastolic) [ Time Frame: Peak value from measurements made every 15-30 min throughout third eight-hour experimental session ]
    Measuring diastolic blood pressure
69. Pre-drug blood pressure [ Time Frame: Prior to drug administration on first experimental session ]
    Measurement of blood pressure as systolic/diastolic
70. Endpoint blood pressure [ Time Frame: Value at 7 h +/- 30 min post-drug on first 8-hour experimental session ]
    Measurement of blood pressure as systolic/diastolic
71. Pre-drug blood pressure [ Time Frame: Value prior to drug administration on second experimental session ]
    Measurement as systolic/diastolic
72. Endpoint blood pressure [ Time Frame: Value 7 h +/- 30 min post-drug on second 8-hour ecxperimental session ]
    Measurement of blood pressure as systolic/diastolic
73. Pre-drug blood pressure [ Time Frame: Value prior to drug administration on third experimental session ]
    Measurement of blood pressure as systolic/diastolic
74. Endpoint blood pressure [ Time Frame: Value 7 h +/- 30 min post-drug on third 8-hour experimental session ]
    Measurement of blood pressure as systolic/diastolic

Eligibility Criteria

• Ages Eligible for Study: 18 Years and older (Adult, Older Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

Criteria

Inclusion Criteria:

• Be diagnosed with chronic PTSD, duration of 6 months or longer resulting from traumatic experience during military service;
• Have a CAPS score showing moderate to severe PTSD symptoms;
• Have had at least one unsuccessful attempt at treatment for PTSD either with talk therapy or with drugs, or discontinuing treatment because of inability to tolerate psychotherapy or drug therapy.
• Are at least 18 years old;
• Must be generally healthy;
• Must sign a medical release for the investigators to communicate directly with their therapist and doctors;
• Are willing to refrain from taking any psychiatric medications during the study period;
• Willing to follow restrictions and guidelines concerning consumption of food, beverages, and nicotine the night before and just prior to each experimental session;
• Willing to remain overnight at the study site;
• Agree to have transportation other than driving themselves home or to where they are staying after the integrative session on the day after the MDMA session;
• Are willing to be contacted via telephone for all necessary telephone contacts;
• Must have a negative pregnancy test if able to bear children, and agree to use an effective form of birth control;
• Must provide a contact in the event of a participant becoming suicidal;
• Are proficient in speaking and reading English;
• Agree to have all clinic visit sessions recorded to audio and video
• Agree not to participate in any other interventional clinical trials during the duration of this study.

Exclusion Criteria:

5.3.2 Exclusion Criteria:

• Are pregnant or nursing, or if a woman who can have children, those who are not practicing an effective means of birth control;
• Weigh less than 48 kg;
• Are abusing illegal drugs;
• Are unable to give adequate informed consent;
• Upon review of past and current drugs/medication must not be on or have taken a medication that is exclusionary.
• Upon review of medical or psychiatric history must not have any current or past diagnosis that would be considered a risk to participation in the s

Contacts and Locations

Locations

United States, South Carolina

Offices of Michael Mithoefer

Mount Pleasant, South Carolina, United States, 29464-4345

Sponsors and Collaborators

Multidisciplinary Association for Psychedelic Studies

Investigators

• Principal Investigator: Michael C Mithoefer, MD; Private Practice

More Information

Publications of Results:

Mithoefer MC, Mithoefer AT, Feduccia AA, Jerome L, Wagner M, Wymer J, Holland J, Hamilton S, Yazar-Klosinski B, Emerson A, Doblin R. 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy for post-traumatic stress disorder in military veterans, firefighters, and police officers: a randomised, double-blind, dose-response, phase 2 clinical trial. Lancet Psychiatry. 2018 Jun;5(6):486-497. doi: 10.1016/S2215-0366(18)30135-4. Epub 2018 May 1.

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

Jerome L, Feduccia AA, Wang JB, Hamilton S, Yazar-Klosinski B, Emerson A, Mithoefer MC, Doblin R. Long-term follow-up outcomes of MDMA-assisted psychotherapy for treatment of PTSD: a longitudinal pooled analysis of six phase 2 trials. Psychopharmacology (Berl). 2020 Aug;237(8):2485-2497. doi: 10.1007/s00213-020-05548-2. Epub 2020 Jun 4.

Feduccia AA, Jerome L, Yazar-Klosinski B, Emerson A, Mithoefer MC, Doblin R. Breakthrough for Trauma Treatment: Safety and Efficacy of MDMA-Assisted Psychotherapy Compared to Paroxetine and Sertraline. Front Psychiatry. 2019 Sep 12;10:650. doi: 10.3389/fpsyt.2019.00650. eCollection 2019. Review.

Mithoefer MC, Feduccia AA, Jerome L, Mithoefer A, Wagner M, Walsh Z, Hamilton S, Yazar-Klosinski B, Emerson A, Doblin R. MDMA-assisted psychotherapy for treatment of PTSD: study design and rationale for phase 3 trials based on pooled analysis of six phase 2 randomized controlled trials. Psychopharmacology (Berl). 2019 Sep;236(9):2735-2745. doi: 10.1007/s00213-019-05249-5. Epub 2019 May 7.

• Responsible Party: Multidisciplinary Association for Psychedelic Studies
• ClinicalTrials.gov Identifier: NCT01211405
• Other Study ID Numbers: MP-8
• First Posted: September 29, 2010
• Last Update Posted: September 26, 2018
• Last Verified: September 2018

Individual Participant Data (IPD) Sharing Statement:

• Plan to Share IPD: Yes
• Plan Description: We will share outcome data appearing in any published reports upon request.
• Supporting Materials: Study Protocol; Statistical Analysis Plan (SAP); Informed Consent Form (ICF)
• Time Frame: Data and study-related documents will be available when all participants have completed the study
• Access Criteria: Interested persons should correspond with the central contact for the study.

Keywords provided by Multidisciplinary Association for Psychedelic Studies:

MDMA; Psychotherapy; Veterans; Posttraumatic Stress Disorder

Additional relevant MeSH terms:

Disease; Stress Disorders, Traumatic; Stress Disorders, Post-Traumatic; Pathologic Processes; Trauma and Stressor Related Disorders; Mental Disorders; N-Methyl-3,4-methylenedioxyamphetamine; Hallucinogens; Physiological Effects of Drugs; Psychotropic Drugs; Serotonin Agents; Neurotransmitter Agents; Molecular Mechanisms of Pharmacological Action; Adrenergic Uptake Inhibitors; Neurotransmitter Uptake Inhibitors; Membrane Transport Modulators; Adrenergic Agents