MDMA's FDA Pause: An Opportunity to Amplify Approved PTSD Treatments

Stepan Popov/AdobeStock

COMMENTARY

Recent discussions surrounding posttraumatic stress disorder (PTSD) treatments have largely focused on the potential approval of MDMA-assisted therapy. While this development is definitely noteworthy and has created valuable awareness about mental health and the need for new treatments, it is crucial to recognize that the narrative often overlooks existing US Food and Drug Administration (FDA)-approved treatments that are already making a significant impact on patients' lives. This oversight not only does a disservice to those seeking immediate help but also potentially delays access to effective, less controversial treatments that are readily available.

Many publications have inaccurately juxtaposed unconventional therapies against a limited number of traditional treatment options, suggesting that novel therapies like MDMA represent the only hope for progress. This perspective fails to acknowledge the existence and efficacy of approved treatments that are already making a positive impact in patients' lives. By expanding our understanding of what is available, we can both empower patients and enable health care providers to make informed decisions about the most appropriate treatment for each individual patient.

The FDA's recent decision to delay approval for MDMA-assisted therapy underscores the complexities involved in introducing new treatments for mental health conditions. While we should remain open to innovative approaches, it is equally important to ensure patients and health care providers are aware of the full spectrum of available evidence-based options.

Nonpharmacological treatments offer several advantages. They provide immediate accessibility, allowing patients to begin treatment without waiting for potential future approvals. These treatments have already undergone rigorous FDA review processes, establishing a proven safety profile. Many nonpharmacological options can be administered in the comfort of one's home, reducing barriers to access. Additionally, treatments that do not rely on pharmaceuticals may have fewer physical adverse effects, which can be a significant consideration for many patients.

One such example is Freespira, a 28-day at-home treatment for PTSD and panic disorder that has demonstrated significant efficacy in reducing symptoms without the need for medication or intensive medical monitoring. With 86% of patients reporting a clinically significant reduction in symptoms after treatment, Freespira exemplifies the power of medication-free, evidence-based solutions in addressing the needs of those suffering from PTSD.

It is important to note the goal is not to dismiss MDMA-assisted therapy or other novel approaches. Rather, we must strive for a more balanced and comprehensive dialogue about PTSD treatments. This includes acknowledging the value of both existing and emerging therapies and understanding that different approaches may be suitable for different individuals.

As mental health professionals, our primary concern should be ensuring that those suffering from PTSD have access to effective treatments as quickly as possible. By broadening the conversation to include all FDA-cleared options, we can help patients make informed decisions about their care and potentially find relief sooner.

As a society, we must prioritize advocacy for the widespread promotion of treatments that offer not only symptom relief but also long-term safety and sustainability. This requires a significant shift in our collective mindset, moving away from a singular focus on novel pharmacological interventions and towards a more comprehensive and transparent approach that values the contributions of diverse therapeutic modalities.

While the pursuit of new and potentially groundbreaking treatments for PTSD is both commendable and necessary, we should not lose sight of the effective solutions already available. By promoting a more comprehensive understanding of PTSD treatment options, we can ensure that patients have access to the full range of therapies that might help them on their journey to recovery.

As we move forward, let's commit to a more inclusive dialogue that recognizes the value of all evidence-based treatments in our collective effort to combat PTSD and improve mental health outcomes. By embracing a holistic approach that recognizes the value of both novel and established therapies, we can create a more supportive and complete mental health landscape that meets all patients immediately where they need support and leaves no one behind.

Dr Closson is a double-board-certified adult and child and adolescent psychiatrist with a specialization in trauma, anxiety, and PTSD. As the CEO of Closson Psychiatric Consultants, LLC, she treats patients with a wide array of mental health issues. She also works as the behavioral health medical director and a child and adolescent psychiatrist at Optum.