ABSTRACT
This chapter aims to critically evaluate methamphetamine derivative (MDMA) proposal from a psychobiological perspective. It overviews the early years of MDMA-assisted psychotherapy up to 1986, when MDMA was scheduled as a Class A drug. The chapter also reviews the psychobiology of MDMA, focusing on its diverse mood effects, while also covering other psychobiological functions. It presents a detailed psychobiological analysis of the processes thought to underlie MDMA-assisted psychotherapy. Psychotherapists label MDMA an 'entactogen' which allows the person to get in contact with their 'true self'. Acute MDMA is followed by a period of neurochemical recovery, when many different psychobiological indices of wellbeing are impaired. Oxytocin might provide a more focused co-drug for post-traumatic stress disorder (PTSD) therapy. Future trials of MDMA-assisted therapy should include active control conditions, using drugs with known efficacy for PTSD. The public misunderstands the core notions of MDMA-assisted psychotherapy; people may mistakenly believe that MDMA is safe to take and can resolve clinical distress.
