Affiliations: [a]
Department of Veteran Affairs, VISN-22 Mental Illness Research Education Clinical Center, Los Angeles, CA, USA
| [b]
Semel Institute for Neuroscience and Human Behavior, University of California - Los Angeles, Los Angeles, CA, USA
| [c]
Hatos Center for Neuropharmacology, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California - Los Angeles, Los Angeles, CA, USA
| [d]
Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
Correspondence:
[*]
Address for correspondence: Walter Dunn, MD, PhD. E-mail: wdunn@mednet.ucla.edu.
Abstract: BACKGROUND:Neurorehabilitation in military populations is complicated by higher rates of PTSD and unique characteristics of military institutions. These factors can adversely impact the patient-therapist therapeutic alliance and engagement with the rehabilitation process leading to poorer outcomes. MDMA is a non-classical psychedelic with pro-social and fear regulating properties. MDMA-assisted therapy is being explored as a novel treatment for PTSD that potentially offers rapid symptom improvement and enhances therapeutic alliance. OBJECTIVE:A review of MDMA-assisted therapy for PTSD is provided in the context of neurorehabilitation in military populations. The molecular mechanism of MDMA is outlined and a novel application of MDMA for neurorehabilitation is proposed. METHODS:This is an expert review and synthesis of the literature. RESULTS:Results from late-stage clinical trials suggest MDMA-assisted therapy for PTSD would be of particular benefit for military populations with PTSD. The unique pro-social properties of MDMA could be leveraged to enhance the therapeutic alliance and patient engagement during neurorehabilitation. CONCLUSION:The unique qualities and benefits of MDMA and MDMA-assisted therapy for PTSD suggest relevant application in military personnel undergoing neurorehabilitation. There are many similarities in patient-therapist dynamics in PTSD treatment and neurorehabilitation. The properties of MDMA which enhance therapeutic alliance, downregulate fear, and increase cognitive flexibility would potentially benefit both military personnel with and without PTSD undergoing neurorehabilitation.
Keywords: MDMA, PTSD, neurorehabilitation, rehabilitation, military personnel, psychedelics
