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

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT01211405
Recruitment Status : Completed
First Posted : September 29, 2010
Results First Posted : February 2, 2022
Last Update Posted : July 11, 2022
Sponsor:
Information provided by (Responsible Party):
Multidisciplinary Association for Psychedelic Studies

Brief Summary:
This study is designed to provide information on whether therapy ("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: Therapy Phase 2

Detailed Description:

Posttraumatic stress disorder (PTSD) is a debilitating mental disorder, that can develop after service in the armed forces. Therapy performed along with MDMA is an innovative form of therapy for PTSD. 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 therapy 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 therapy in veterans with chronic PTSD. 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 therapy sessions one month after the second experimental session.

After undergoing three 90-minute non-drug introductory therapy 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 therapy 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.

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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 Therapy 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


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 at start of an experimental session. Upon mutual agreement, this may be followed by a supplemental dose of 15 mg MDMA 1.5 to 2 hours later
Other Names:
  • MDMA
  • (+/-)-3,4-methylenedioxymethamphetamine
  • methylenedioxymethamphetamine

Behavioral: Therapy
Non-directive therapy during each session

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 administered p.o. once at start of an experimental session. Upon mutual agreement, this may be followed by a supplemental dose of 37.5 mg MDMA 1.5 to 2 hours later
Other Names:
  • MDMA
  • (+/-)-3,4-methylenedioxymethamphetamine
  • methylenedioxymethamphetamine

Behavioral: Therapy
Non-directive therapy during each session

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. once at start of an experimental session. Upon mutual agreement, this may be followed by a supplemental dose of 62.5 mg MDMA 1.5 to 2 hours later
Other Names:
  • MDMA
  • (+/-)-3,4-methylenedioxymethamphetamine
  • methylenedioxymethamphetamine

Behavioral: Therapy
Non-directive therapy during each session




Primary Outcome Measures :
  1. Baseline Clinician-Administered PTSD Scale (CAPS-IV) Total Score [ Time Frame: Baseline ]
    The Clinician-Administered PTSD Scale for DSM-IV (CAPS-IV) is a clinician administered and scored assessment of PTSD symptoms via structured interview based upon PTSD diagnosis in DSM-IV. The total severity score is a sum of symptom frequency and intensity scores for the subscales B (re-experiencing), C (avoidance) and D (hypervigilance) and ranges from 0 to 136, with higher scores indicating greater severity of PTSD symptoms.

  2. Primary Endpoint Clinician-Administered PTSD Scale (CAPS-IV) Total Score [ Time Frame: One month after second experimental session ]
    The Clinician-Administered PTSD Scale for DSM-IV (CAPS-IV) is a clinician administered and scored assessment of PTSD symptoms via structured interview based upon PTSD diagnosis in DSM-IV. The total severity score is a sum of symptom frequency and intensity scores for the subscales B (re-experiencing), C (avoidance) and D (hypervigilance) and ranges from 0 to 136, with higher scores indicating greater severity of PTSD symptoms.

  3. Change in Clinician-Administered PTSD Scale (CAPS-IV) From Baseline to Primary Endpoint [ Time Frame: Baseline to one month after second experimental session ]
    The Clinician-Administered PTSD Scale for DSM-IV (CAPS-IV) is a clinician administered and scored assessment of PTSD symptoms via structured interview based upon PTSD diagnosis in DSM-IV. The total severity score is a sum of symptom frequency and intensity scores for the subscales B (re-experiencing), C (avoidance) and D (hypervigilance) and ranges from 0 to 136, with higher scores indicating greater severity of PTSD symptoms.


Secondary Outcome Measures :
  1. Change in Global Assessment of Function (GAF) From Baseline to Primary Endpoint [ Time Frame: Baseline to one month after second experimental session ]
    The Global Assessment of Functioning (GAF) Scale is a numeric scale ranging from 0 through 100 that is used by mental health clinicians and physicians to subjectively rate the social, occupational, and psychological functioning of adults. Higher scores indicate better functioning.

  2. Change in Posttraumatic Growth Inventory (PTGI) From Baseline to Primary Endpoint [ Time Frame: Baseline to one month after second experimental session ]
    The Posttraumatic Growth Inventory (PTGI) is a 21-item self-report measure of perceived growth or benefits occurring after a traumatic event. It contains five subscales; relationship to others, new possibilities, personal strength, spiritual change, and appreciation of life. Questions are answered on a scale from 0 (I did not experience this change) to 5 (I experienced this change to a great degree). Items are added to calculate the total PTGI score which ranges from 0 to 105, with higher scores indicative of greater growth.

  3. Change in Beck Depression Inventory (BDI-II) From Baseline to Primary Endpoint [ Time Frame: Baseline to one month after second experimental session ]
    Validated self-report measure of symptoms of depression. The BDI-II total score of 0-13 is considered minimal range, 14-19 is mild, 20-28 is moderate, and 29-63 is severe depressive symptoms. The BDI-II is scored by summing the ratings for the 21 items. Each item is rated on a 4-point scale ranging from 0 to 3. The maximum total score is 63.

  4. Change in Dissociative Experience Scale (DES-II) From Baseline to Primary Endpoint [ Time Frame: Baseline to one month after second experimental session ]
    The DES-II is a 28-item self-report measure of dissociation, defined as a lack of normal integration of an individual's thoughts, feelings, or experiences into the stream of consciousness or memory. Respondents indicate how often the specific experience happens to them, from "never" (0% of the time) to "always" (100%). The scale is scored by treating percentages as single digits and summing to produce a total score, ranging from 0 to 100. The higher the score, the more dissociative symptoms.

  5. Change in Pittsburgh Sleep Quality Index (PSQI) From Baseline to Primary Endpoint [ Time Frame: Baseline to one month after second experimental session ]
    The Pittsburgh Sleep Quality Index (PSQI) is a self-rated questionnaire which assesses sleep quality and disturbances. It is comprised of 18 items that yield seven component scores. Component scores are summed to create a total score. Total scores range from 0 (better) to 21 (worse), with higher scores indicating poor sleep quality.

  6. Change in Neuroticism-Extroversion-Openness Personality Inventory-Revised (NEO-PI-R) From Baseline to Primary Endpoint [ Time Frame: Baseline to one month after second experimental session ]
    The NEO-PI-R is a 240-item self-report assessment that defines personality structure according to a five-factor model. Items related to neuroticism, extraversion, openness, agreeableness, and conscientiousness are rated on a five-point scale from strongly disagree to strongly agree. T-scores range from 20 to 80 with a mean score of 50. Higher scores in each domain indicating stronger facets of those personality factors. The NEO-PI-R is a measure of personality traits, not psychopathology symptoms.



Information from the National Library of Medicine

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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

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01211405


Locations
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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
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Principal Investigator: Michael C Mithoefer, MD Private Practice
  Study Documents (Full-Text)

Documents provided by Multidisciplinary Association for Psychedelic Studies:
Study Protocol  [PDF] August 14, 2013
Statistical Analysis Plan  [PDF] October 6, 2015
Informed Consent Form  [PDF] August 27, 2013

Publications of Results:
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
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Responsible Party: Multidisciplinary Association for Psychedelic Studies
ClinicalTrials.gov Identifier: NCT01211405    
Other Study ID Numbers: MP-8
First Posted: September 29, 2010    Key Record Dates
Results First Posted: February 2, 2022
Last Update Posted: July 11, 2022
Last Verified: June 2022
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Yes
Plan Description: We will share de-identified outcome data appearing in any published reports upon request. IPD may include de-identified baseline, demographic and outcome measure data. To ensure participant privacy, it will never include PHI. Please contact the central trial contact for details about data sharing and data available.
Supporting Materials: Study Protocol
Statistical Analysis Plan (SAP)
Time Frame: Data and study-related documents will be available following primary publication of outcomes.
Access Criteria: Interested persons should correspond with the central contact for the study.
Keywords provided by Multidisciplinary Association for Psychedelic Studies:
MDMA
Therapy
Veterans
Posttraumatic Stress Disorder
Additional relevant MeSH terms:
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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