Hoe lang is het herstel opgevolgd?
Jammer genoeg is dit niet terug te vinden in het gepubliceerde berichtje. Maar het is zeker een relevante vraag die je stelt, dat getuigt ook de bovenvermelde review:
...The post-ecstasy/MDMA recovery period is often called the ‘midweek blues’ by recreational users. Curran and Travill (1997) noted reduced moods 5 days after taking recreational ecstasy, with several of their participants reporting Beck depression inventory scores within the clinical range. In another prospective study, Parrott and Lasky (1998) found that self-rated sadness and unsociability were significantly increased 2 days after taking Ecstasy/ MDMA, but returned to baseline values within a week. Curran et al. (2004) documented a significant increase in self-rated aggression and depression 4 days after taking Ecstasy/MDMA, and again, these values had returned to normal after 7 days. It is not just mood states which are adversely affected. On a behavioral task, Curran et al. (2004) found a significantly greater aggressiveness bias at the mid-week session. O’Regan and Clow (2004) found a significant decrease in pain threshold (i.e., more pain) during the recovery period. Turner et al. (1998) reported that appetite and food intake were significantly reduced for several days after Ecstasy. To summarize, acute MDMA is followed by a period of neurochemical recovery when many different psychobiological indices of well-being are impaired (Table 2). The concern is that this period may lead to enhanced psychiatric distress especially in susceptible individuals.
An important question is whether taking MDMA leads to any longer term changes in well-being. Greer and Tolbert (1986) noted that several of their participants described enduring benefits, with more positive outlooks, feelings of personal strength, and a greater awareness of being alive; examples of these beneficial changes were given in the first section. However, negative changes were also noted, including the recurrence of anxiety symptoms in someone who had previously suffered from clinical anxiety (details later). This mixture of positive and negative outcomes is also evident in recreational Ecstasy/MDMA users. Rodgers et al. (2006) surveyed 157 recreational users about any negative or positive changes they would attribute to ecstasy use. Content analysis revealed several themes. Around 38% of the sample reported an improved outlook on life: ‘Became more open minded, happy, friendly, positive about life’. Other beneficial themes, reported by smaller proportions of the sample, were greater understanding of the self and increased sociability. The main negative theme to emerge, reported by 32% of the sample, was psychological problems: ‘Depression—anxiety about stupid things—paranoia’. Other negative themes, reported less frequently, included social distress and physical problems such as thermal stress and reduced sex drive. One limitation with all these findings is that their duration was often unclear (Greer and Tolbert 1986; Rodgers et al. 2006). Future research should focus on how long these positive and negative changes endure over time.
Edit: en wat waren de criteria om de patiënten therapie-resistent te noemen?
In het onderzoeksplan van de studie, goedgekeurd door de FDA, vind ik het volgende daarover:
Participants will be unpaid individuals, male or female, ages 18 through 70, who have been diagnosed with current PTSD using DSM-IV criteria, including a score of 50 or above on the Clinician-Administered PTSD Scale (CAPS), a recognized measure of PTSD severity. PTSD was selected for study because it is among the most debilitating of conditions for which there is evidence that MDMA may be effective. There are only two FDA-approved treatment for PTSD (e.g., Zoloft and Paxil) and these treatments are not effective in all patients. There is therefore a substantial need for improved treatments for this debilitating and degenerative illness.
We will recruit only individuals who have failed to achieve remission after treatment with a selective serotonin reuptake inhibitor after at least three months, and after receiving psychotherapy lasting for at least six months, with at least twelve psychotherapy sessions in the course of treatment. Our intention is to recruit participants who, aside from having treatment-resistant PTSD, are physically healthy, as confirmed by detailed medical evaluation, and will not be posed untoward risks by exposure to MDMA. Because of the high co-morbidity of mood and anxiety disorders among people with PTSD, it is necessary to include individuals with these additional diagnoses (excluding bipolar affective disorder). As discussed below, we will only include persons who are not taking or can be safely withdrawn from other prescription medications that might present difficult-to-evaluate risks of drug-drug interaction and that might confound any findings of therapeutic benefit.
uit: Current version of Dr. Michael Mithoefer's MDMA/PTSD study protocol
Aan de andere kant (geparafraseerd):
Patient: You're prescribing me cigarettes? Aren't they adictive and dangerous?
Dr. House: Yes, but all my drugs are addictive and dangerous.
De grens tussen een aantal medicatie en drugs is inderdaad flinterdun...
Wat ik trouwens niet wist, maar ik in m'n zoektocht ben tegengekomen, is dat XTC blijkbaar in de jaren '60 en '70 volop gebruikt werd in de psychotherapie. Aangezien het een middel was om mensen zonder angst iets te laten door-leven... (zie daarvoor het filmpje op http://www.youtube.com/user/teleomorph
...MDMA was first brought to public attention through Dr. Alexander Shulgin in the 1960s who recommended it for use in certain therapy sessions, naming the drug 'window' (he discovered it while searching for compounds that might have a similar psychoactive effect as other compounds contained in nutmeg). It was widely used therapeutically by US psychotherapists (especially on the West Coast) because of its empathogenic effects until its criminalization in the late 1980s, and a small number of therapists continue to use it in their practices today. (See below for 2001 FDA approval and DEA licensing for use in patients with post-traumatic stress disorder.)...
Veranderd door Dido, 27 januari 2010 - 18:38
Ik ben niet jong genoeg om alles te weten...