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Published online 19 November 2008 | Nature 456, 293 (2008) | doi:10.1038/456293d
News in Brief
Ecstasy could augment the benefits of psychotherapy
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These findings are exciting and important. Negatively valenced emotions which chronically persist reduce quality of life and lead to diagnosable psychiatric disorders. This should be obvious by the simple fact that stress is inextricably linked to numerous psychiatric disorders, especially the mood and anxiety disorders. Therefore increasing extinction rates of negatively valenced emotions should be a main goal for modern psychiatry. Current treatments are inadequate and beholden to a model of chronic pharmaceutical drug treatment. In many cases a better model might be drug-facilitated psychotherapy, where an acutely acting drug would be given at or near the time of psychotherapy to enhance learning and reduce fear during the psycho-therapeutic process. This model is starting to gain momentum with the use of D-cycloserine to enhance extinction rates in patients with simple phobias and social phobia. An important question is why the NIH is not funding more studies like this, or better yet why more preclinical studies examining MDMA or MDMA-like drugs in animal models of fear/anxiety/depression are not being conducted. Most studies of MDMA in animal models have been focused on inducing serotonergic cell death by using excessive doses of MDMA that are non-clinically relevant. This is comparable to studying the effects of aspirin, but only investigating doses that induce liver damage (something is wrong here). MDMA may not be a panacea, but let us do the research so we can adequately assess its potential. Jon Ploski, Yale University