Psychotherapy sessions in which patients are given controlled doses of the psychoactive drug MDMA (MDMA-assisted psychotherapy) may be beneficial in reducing symptoms of social anxiety in autistic people, early stage research suggests.
The results of the first clinical trial of MDMA-assisted therapy for the treatment of social anxiety have been published in the journal Psychopharmacology, with the findings showing significant and lasting reductions in symptoms.
The small pilot study, which was sponsored by the non-profit Multidisciplinary Association for Psychedelic Studies (MAPS), involved 12 participants who were all adults on the autism spectrum with marked to very severe social anxiety.
The participants took part in two sessions of psychotherapy during which eight received a dose of MDMA while the other four were given an inactive placebo. All participants also received additional preparatory and integrative sessions.
The team conducting the experiment from the Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center were unaware of whether the participants had been given the placebo or the MDMA in order to eliminate bias in the results—what's known as a double-blind study.
When the researchers followed up on the participants in the months after the therapy sessions, they found that reductions in measures of social anxiety were significantly greater for the individuals who had received MDMA-assisted psychotherapy than for those who had received the placebo.
On a test which is commonly used to assess the impact of social phobia, known as the Liebowitz Social Anxiety Scale (LSAS), the placebo group experienced reductions of 19.3 points on average compared to 44.1 points for the MDMA group.
"What was particularly notable for many of the participants after treatment was their increased self-confidence when interacting in social settings, an endeavor that in the past they had experienced as overwhelming," Charles Grob, an author of the study, said in a statement.
Participants who had received the MDMA-assisted psychotherapy reported increased confidence in social interactions at school, in friendships, at work and in romantic relationships.
"I felt like I was experiencing my best self and seeing the world for the first time and seeing myself for the first time," one participant noted. Another said: "I realized communication is not just about talking. Now, I take time to notice my emotions and others' emotions before talking."
Furthermore, the results of the study demonstrated that limited doses of MDMA in controlled therapeutic settings were safe. There were no serious adverse reactions among the participants during the experiments, although anxiety and difficulty concentrating were frequently reported.
Other unwanted side effects included fatigue, headaches, sensitivity to cold, and elevations in pulse, blood pressure and temperature, although none of these required medical interventions.
"We hope that our study will help to establish a foundation for future investigations exploring the safety and efficacy of MDMA in the treatment of social anxiety in vulnerable patient populations," Grob said.
The latest research was conducted in response to a previous survey of adults with autism who were asked about their MDMA experiences in recreational settings. In the survey, 91 percent of participants reported increased feelings of empathy or connectedness and 86 percent reported being able to communicate much more easily.
David Nutt, a neuropsychopharmacologist at Imperial College London specializing in the research of drugs that affect the brain, described the results of the new study as "very interesting."
"They show for the first time in people with autism that MDMA has prosocial effects," he told Newsweek. "[They] also suggest it might now be rolled out as a treatment—but [we] need to remove [MDMA] from the U.N. Drug Control Conventions as a Schedule 1 drug, which severely limits research."
Autism is a lifelong developmental disability that affects how people perceive the world and interact with others. The autism spectrum contains a range of similar disorders, such as Asperger's syndrome.
Individuals on this spectrum frequently suffer social anxiety, however, conventional anti-anxiety medications are often ineffective for people with autism. There are currently no FDA-approved drugs specifically for adults with autism with social anxiety, meaning any potential new treatments, such as the MDMA-assisted therapy, will be viewed with interest.
It is important to note that the latest study involved a very small sample size so its findings should be regarded with caution until further research can be carried out.
MDMA-assisted psychotherapy has previously shown promise in the treatment of a variety of conditions ranging from post-traumatic stress disorder to depression and alcohol addiction.
This article has been updated to include additional comments from David Nutt.
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