8/16/2011, The Agony and the Ecstasy: The Quiet Mission to Fight PTSD With MDMA

http://motherboard.vice.com/blog/the-agony-and-the-ecstasy-the-quiet-mission-to-fight-ptsd-with-psychedelic-drugs

We’re all subject to this at any age, science says. But in the United States we’re breeding the disorder within the military at staggering rates. Over 70,000 veterans received PTSD disability support in 2005. One study, as the Economist reported in 2008, “estimated that 12 percent of American veterans from the wars in Iraq and Afghanistan suffer from PTSD.” Last year, The New York Times figured “well over” 300,000 troops had returned with PTSD, depression, traumatic brain injury, “or some combination of those.”

Distressed veterans and active-duty troops can take antidepressants like sertraline (Zoloft) or paroxetine (Paxil), the two FDA-approved SSRI (selective serotonin reuptake inhibitor) medications for adult PTSD. (Under a recent settlement between veterans and the military and stemming from a 2008 class-action lawsuit, more than a thousand Iraq and Afghanistan veterans with the disorder would be given lifetime disability retirement benefits such as military health insurance.) The FDA says these are relatively safe, but warns of unintentional side effects: “worsening depression, suicidal thinking or behavior” and “sleeplessness, agitation, or withdrawal from normal social situations.” One recent study claims those on antidepressants are “much more” prone to relapse into major depression than the non-medicated.

The military’s medical program has over the past decade developed a knack for throwing prescription drugs at the mental health problem, so much so that the Army now limits how many addictive painkillers any soldier can acquire at any one time…

Between 2006 and 2009 over a hundred military personnel have died accidentally due to toxic prescription-drug blends. Illicit self-medicating, the default for so many Vietnam-era troops, is falling out of favor among newer veterans. Now, vets are five times more likely to abuse pills and alcohol than weed or coke or heroin…

The Government Accountability Office also just concluded that the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, created in 2007 when Congress tasked the Pentagon with establishing a program for handling influxes of brain injuries and PTSD among veterans, has no idea what it’s doing…

It may be unsurprising, then, to learn that suicide rates across the Department of Defense rose by about 50 percent between 2001 and 2008. Nor is it surprising that active-duty suicides topped battlefield casualties in 2009, or that a dozen reserve soldiers killed themselves last March, or even that some experts, according to the Times story, consider exposure therapy (a form of cognitive-behavioral psychotherapy) the “only proven treatment” for PTSD…

“They have irreversible bindings on some receptors in the brain,” he explained, “which can potentially result in maybe greater or longer-term side effects for an individual.” SSRIs, he claimed, are reversible.

Are they?

Of course, the effects and promise of various PTSD drugs mean nothing when many of those most in need of treatment are reluctant to seeking treatment in the first place. Writing in an editorial that ran with a study published last week in the Journal of the American Medical Association, Hoge not only suggested that a whole class of antipsychotics, including Risperdal, Seroquel, Geodon, and Abilify, can’t top placebos. He points to the bigger, more pervasive problem: Half of veterans who can’t shut out the mental sirens, and who should seek care, don’t…

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