ESTD

The use of innovative drugs in the treatment of (severe) PTSD: New findings and perspectives January 16 2024, at 7-8.30pm

Reviewing matrix of psychedelics in PTSD treatment

Prof. Col ret’d Eric Vermetten, MD, PhD

Abstract

Post-Traumatic Stress Disorder (PTSD) remains one of the most debilitating mental conditions, often resistant to conventional treatments. After the standing history of the use of LSD for PTSD reactions in concentration camp survivor syndrome in the Netherlands by Jan Bastiaans there has been a long silent period in research and clinical use of psychedelics. Recently, there has been a resurgence in interest regarding the therapeutic potential of psychedelics for PTSD. Psychedelics, such as MDMA, psilocybin, and ayahuasca, have shown promising results in early-stage clinical trials. MDMA, has been explored in conjunction with talk therapy. Preliminary results suggest that it might help patients confront traumatic memories more directly, without the usual intense emotional response, facilitating therapeutic breakthroughs. Similarly, psilocybin, has demonstrated the potential to reset certain neural pathways, allowing patients a fresh perspective on traumatic events. Ayahuasca, a traditional Amazonian plant brew, has anecdotal support for treating various mental health ailments, including PTSD, although research in this area is still emerging. While these substances offer exciting potential, challenges remain. Ongoing concerns include standardized dosing, understanding long-term effects, and integration with traditional therapies. If is important to learn from and connect with alterations in consciousness experiences with progression to treatment. Yet, the potential for a shift towards metacognitive experiential change in PTSD treatment is undeniable. As research continues, psychedelics may be essential in relieving those suffering from trauma’s profound impacts.

MDMA-assisted therapy and Somatic - Acceptance based therapy (SEA-IT), shared and differential mechanisms of change. A new study into treatment for veteran PTSD and moral injury.

Dr. Anna Harwood-Gross

Abstract:

Despite being exposed to a high level of potentially traumatic experiences due to exposure to combat, military veterans have poor response rates to traditional PTSD treatments. In recent years 3,4-Methylenedioxymethamphetamine (MDMA) has demonstrated a significant treatment potential for severe and treatment resistant PTSD, though not specifically in a veteran population. There are still major gaps in the theoretical literature and the mechanisms of change are, as yet, unexplored. By examining the proposed mechanisms by which MDMA Assisted Therapy (MDMA-AT) enhances the “window of tolerance” for PTSD therapy, specifically in those with comorbid symptoms of moral injury, we hope to delineate treatment pathways, suitability for treatment and key treatment characteristics. Given the high success rate of the placebo group in the original MDMA-AT studies for PTSD, we will be studying MDMA-AT alongside SEA-IT, a somatic and acceptance based treatment following the unique MDMA-AT session structure including long sessions and overnight recovery, integration sessions and cyclical trauma processing.

We recommend the following key articles by the speakers:

Burback, L., Brémault-Phillips, S., Nijdam, M. J., McFarlane, A., & Vermetten, E. (2023). Treatment of Posttraumatic Stress Disorder: A State-of-the-art Review. Curr. Neuropharmacol.

Krediet, E., Bostoen, T., Breeksema, J., van Schagen, A., Passie, T., & Vermetten, E. (2020). Reviewing the potential of psychedelics for the treatment of PTSD. International Journal of Neuropsychopharmacology, 23(6), 385-400.

Nijdam, M. J., Vermetten, E., & McFarlane, A. C. (2023). Toward staging differentiation for posttraumatic stress disorder treatment. Acta Psychiatrica Scandinavica, 147(1), 65-80.

Harwood-Gross, A., Vayngrib, M., & Halperin, E. (2023). Moral Injury as a Social Phenomenon: Looking at the Unique Relationship with System Justification. Journal of Aggression, Maltreatment & Trauma, 1-18.

Harwood-Gross, A., Stern, N., Brom, D. (2023). Exposure to combat experiences: PTSD, somatization and aggression amongst combat and non-combat veterans. International Journal of Psychology.

Harwood-Gross, A., Weltman, A., Kanat-Maymon, Y., Pat-Horenczyk, R., & Brom, D. (2022). Peace of mind: Promoting psychological growth and reducing the suffering of combat veterans. Military Psychology, 1-11.

Prof. Col ret’d Eric Vermetten, MD, PhD, is currently professor and clinical psychiatrist at Leiden University Medical Center in the Netherlands. He has had several roles in the Dutch Armed Forces as Head of Research and Strategic Advisor (COL) of Research at the Military Mental Health Service, and ARQ National Psychotrauma Center. He also has an Adjunct Professorship at the Department Psychiatry of New York UMC. He is trained in the Netherlands as well as in the USA in psychiatry and neuroscience (Stanford, Yale and Emory University). He has clinical as well as a research positions with a focus on medical/biological as well as psychiatric aspects of complex psychotrauma in military as well as civilian populations.He has explored roots of psychotherapy and is pioneering in delivering psychotherapy with novel technological and psychedelic support. His work not only informs clinical practice but also influences policies and interventions for trauma-affected populations. He is consulting for professional organisations (United Nations, Veterans Institutes and other international organisations).

Dr. Anna Harwood-Gross is a Clinical Psychologist and Director of Research at METIV: The Israel Psychotrauma Center. She studies PTSD and moral injury amongst clinical and sub-clinical populations with high exposure to potentially traumatic or morally injurious events. She is currently running multiple trials of individual and group treatments for trauma exposure and PTSD with a particular interest in the integration of societal, individual and physiological interventions for complex populations. In her clinical practice, she specializes in complex trauma and attachment difficulties.

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