MDMA-Assisted Psychotherapy for Anxiety Associated With a Life-Threatening Illness

This Phase 2 pilot study is a randomized, double-blind, placebo-controlled study in 18 participants comparing the effects of MDMA-assisted therapy vs. placebo with therapy. Thirteen participants were randomized to the active dose condition of 125 mg of MDMA (plus an optional supplemental dose of 62.5 mg MDMA) with therapy and five participants were randomized to the placebo with therapy condition. The study will consist of two blinded experimental sessions of MDMA-assisted therapy or placebo with therapy, each session lasting six to eight hours and scheduled two to four weeks apart. Each participant will be unblinded one month after their second experimental session in Stage 1. After unblinding, participants receiving placebo will have the opportunity to cross over to open-label Stage 2 and receive active MDMA. Only subjects who receive active dose MDMA will complete an optional third open-label experimental session.

Individuals facing, or who have faced, a life-threatening illness contend with more than just the physical symptoms of their condition and may experience anxiety, depression, anger, and despair that can exacerbate their distress. Research suggests that diagnosis of, and living with a life-threatening illness can result in symptoms similar to those seen in posttraumatic stress disorder (PTSD).

3,-4-methylenedioxymethamphetamine (MDMA) is a monoamine releaser with a unique pharmacological profile that include decreased feelings of fear, increased positive mood and increased interpersonal trust. Findings from clinical trials in people with PTSD and anecdotal reports suggest that MDMA-assisted psychotherapy may assist people who have anxiety related to having a life-threatening illness.

This Phase 2 pilot study is a randomized, double-blind, placebo-controlled study in 18 participants comparing the effects of MDMA-assisted therapy vs. placebo with therapy. Thirteen participants were randomized to the active dose condition of 125 mg of MDMA (plus an optional supplemental dose of 62.5 mg MDMA) with therapy and five participants were randomized to the placebo with therapy condition. The study will consist of two blinded experimental sessions of MDMA-assisted therapy or placebo with therapy, each session lasting six to eight hours and scheduled two to four weeks apart. Each participant will be unblinded one month after their second experimental session in Stage 1. After unblinding, participants receiving MDMA will complete a third open-label experimental session of MDMA-assisted therapy and participants who originally received placebo will have the opportunity to cross over to open-label Stage 2 and receive active MDMA-assisted therapy in 3 sessions.

The primary objective of the study is to assess changes in trait anxiety in subjects receiving active dose MDMA compared to those receiving placebo as measured by State-Trait Anxiety Index (STAI) Trait scores from Baseline to the Primary Endpoint (one month after the second experimental session).

Eligibility Criteria:
Inclusion Criteria:

* Diagnosed with life-threatening cancer or non-dementing neurological illness, which can be ongoing or in remission, but with a possibility of recurrence
* Prognosis of at least nine months life expectancy from the time of screening
* Have anxiety as a result of facing their illness
* Are at least 18 years old
* Are willing to refrain from taking any psychiatric medications during the study period;
* Are willing to commit to medication dosing, experimental sessions, follow-up sessions, and to complete evaluation instruments
* Are willing to remain overnight at the study site after each experimental session until after the integrative session occurring the next morning
* Must sign a medical release for the investigators to communicate directly with their therapist and doctors;
* Are willing to select up to three observers who will complete observer measures of subject attitudes and behavior
* Negative pregnancy test if able to bear children and agree to use effective birth control
* Are proficient in speaking and reading English
* Agree to have all psychotherapy sessions recorded to audio/video.

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, 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