Posttraumatic Stress Disorder
Conditions
Keywords
MDMA, PTSD, therapy
Brief summary
This study will consist of a single session of MDMA-assisted therapy with a full dose of MDMA for people who took part in a study of MDMA-assisted therapy in people with posttraumatic stress disorder (PTSD) whose PTSD symptoms returned to higher levels at least a year after the first MDMA sessions. The single session will be performed by the same pair of therapists who performed the sessions in the first study. People will have a preparatory session, the MDMA-assisted session and three non-drug sessions afterward. Their PTSD symptoms and symptoms of depression will be measured at the start of this study and two and 12 months after the session.
Detailed description
This study will investigate the effects of an additional 3,4-methylenedioxymethamine (MDMA)-assisted therapy session in up to three participants with PTSD who relapsed after their PTSD symptoms had significantly decreased during MAPS' initial U.S. Phase 2 trial testing the use of MDMA-assisted therapy in subjects with chronic, treatment-resistant posttraumatic stress disorder PTSD). This new protocol will consist of a single, full-dose open-label session of MDMA-assisted therapy, along with associated non-drug preparation and integrative therapy sessions. MDMA is an investigational drug that was studied in a randomized, placebo-controlled study in 21 participants, and it included a final evaluation of symptoms at least one year after taking part in the study. While PTSD symptoms in most study subjects stayed at the same levels from when they completed the study, symptoms had returned in a few people. This open-label study is intended to see if an additional MDMA-assisted session conducted at least 14 months after the first sessions can help reduce PTSD symptoms. The MDMA-assisted therapy session will be conducted by a male and female co-therapist team, one a psychiatrist and the other a psychiatric nurse. Vital signs (blood pressure, pulse and body temperature) and psychological distress will be measured throughout the experimental session. After the experimental session they will spend the night in the clinic with an attendant on duty, and complete a measure of alterations in consciousness, the States of Consciousness Questionnaire (SCQ) on the evening or day following the experimental session. Participants will meet with the investigators the next morning for an integrative therapy session before leaving the clinic. During integrative therapy sessions they will receive support in integrating their experiences and insights from the MDMA-assisted therapy session. There will be daily phone contact with one of the investigators for 7 days after the experimental session. Symptoms of PTSD, depression and general function will be assessed two months after the experimental session. There will be a long-term follow up with repeated outcome measures 12 months after the experimental session
Interventions
DRUGMidomafetamine
125 mg MDMA followed by 62.5 mg MDMA 1.5 to 2.5 hours later
BEHAVIORALTherapy
Non-directive therapy
Sponsors
Lykos Therapeutics
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Be diagnosed with chronic PTSD; * Have a CAPS score showing moderate to severe PTSD symptoms; * Have participated in MP-1; * 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
* 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 study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Baseline Clinician-Administered PTSD Scale for DSM-IV (CAPS-IV) | Less than 4 weeks before first experimental session | The CAPS-IV is a structured clinical interview designed to assess the symptoms and severity of PTSD. The CAPS-IV provides a means to evaluate the frequency and intensity dimensions of each symptom, the impact of symptoms on the patient's social and occupational functioning, the overall severity of the symptom complex, global improvement since baseline, and the validity of the ratings obtained. Total severity scores range from 0 to 136, with higher scores indicating greater severity of PTSD symptoms. |
| Clinician-Administered PTSD Scale for DSM-IV (CAPS-IV) at 2-month Follow-up | 2 months post experimental session | The CAPS-IV is a structured clinical interview designed to assess the symptoms and severity of PTSD. The CAPS-IV provides a means to evaluate the frequency and intensity dimensions of each symptom, the impact of symptoms on the patient's social and occupational functioning, the overall severity of the symptom complex, global improvement since baseline, and the validity of the ratings obtained. Total severity scores range from 0 to 136, with higher scores indicating greater severity of PTSD symptoms. |
| Clinician-Administered PTSD Scale (CAPS-IV)) at 12-month Follow-up | 12 months post 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. |
| Change in Clinician-Administered PTSD Scale (CAPS-IV) From Baseline to 2-month Follow-up | Baseline to 2 months post 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. |
| Change in Clinician-Administered PTSD Scale (CAPS-IV) From Baseline to 12-month Follow-up | Baseline to 12 months post 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. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| 3,4-methylenedoxymethamphetamine (MDMA)-Assisted Therapy 3,4-methylenedioxymethamphetmine (MDMA): 125 mg MDMA followed by 62.5 mg MDMA 1.5 to 2.5 hours later
MDMA-AT: MDMA-assisted therapy | 3 |
| Total | 3 |
Baseline characteristics
| Characteristic | 3,4-methylenedoxymethamphetamine (MDMA)-Assisted Therapy |
|---|---|
| Age, Continuous | 46.9 years STANDARD_DEVIATION 7.79 |
| Sex: Female, Male Female | 3 Participants |
| Sex: Female, Male Male | 0 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 0 / 3 |
| other Total, other adverse events | 1 / 3 |
| serious Total, serious adverse events | 1 / 3 |
Outcome results
Primary
Baseline Clinician-Administered PTSD Scale for DSM-IV (CAPS-IV)
The CAPS-IV is a structured clinical interview designed to assess the symptoms and severity of PTSD. The CAPS-IV provides a means to evaluate the frequency and intensity dimensions of each symptom, the impact of symptoms on the patient's social and occupational functioning, the overall severity of the symptom complex, global improvement since baseline, and the validity of the ratings obtained. Total severity scores range from 0 to 136, with higher scores indicating greater severity of PTSD symptoms.
Time frame: Less than 4 weeks before first experimental session
Population: Intent-to-treat
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| 3,4-methylenedoxymethamphetamine (MDMA)-Assisted Therapy | Baseline Clinician-Administered PTSD Scale for DSM-IV (CAPS-IV) | 93.3 score on a scale | Standard Deviation 1.53 |
Primary
Change in Clinician-Administered PTSD Scale (CAPS-IV) From Baseline to 12-month Follow-up
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.
Time frame: Baseline to 12 months post experimental session
Population: Intent-to-treat
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| 3,4-methylenedoxymethamphetamine (MDMA)-Assisted Therapy | Change in Clinician-Administered PTSD Scale (CAPS-IV) From Baseline to 12-month Follow-up | -40.7 score on a scale | Standard Deviation 40.27 |
Primary
Change in Clinician-Administered PTSD Scale (CAPS-IV) From Baseline to 2-month Follow-up
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.
Time frame: Baseline to 2 months post experimental session
Population: Intent-to-treat
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| 3,4-methylenedoxymethamphetamine (MDMA)-Assisted Therapy | Change in Clinician-Administered PTSD Scale (CAPS-IV) From Baseline to 2-month Follow-up | -62.0 score on a scale | Standard Deviation 12.53 |
Primary
Clinician-Administered PTSD Scale (CAPS-IV)) at 12-month Follow-up
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.
Time frame: 12 months post experimental session
Population: Intent-to-treat
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| 3,4-methylenedoxymethamphetamine (MDMA)-Assisted Therapy | Clinician-Administered PTSD Scale (CAPS-IV)) at 12-month Follow-up | 52.7 score on a scale | Standard Deviation 39.63 |
Primary
Clinician-Administered PTSD Scale for DSM-IV (CAPS-IV) at 2-month Follow-up
The CAPS-IV is a structured clinical interview designed to assess the symptoms and severity of PTSD. The CAPS-IV provides a means to evaluate the frequency and intensity dimensions of each symptom, the impact of symptoms on the patient's social and occupational functioning, the overall severity of the symptom complex, global improvement since baseline, and the validity of the ratings obtained. Total severity scores range from 0 to 136, with higher scores indicating greater severity of PTSD symptoms.
Time frame: 2 months post experimental session
Population: Intent-to-treat
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| 3,4-methylenedoxymethamphetamine (MDMA)-Assisted Therapy | Clinician-Administered PTSD Scale for DSM-IV (CAPS-IV) at 2-month Follow-up | 31.3 score on a scale | Standard Deviation 12.01 |