Summary: Cases of PTSD are on the rise globally, yet there are very few effective treatments for the condition. To date, psychotherapy is the most effective way of managing the condition. New studies show that MDMA or psilocybin may significantly increase the effectiveness of psychotherapy. It appears that these substances, when used as medications or part of PTSD treatment, make individuals more receptive to psychotherapy, thus helping rewire the brain faster.

Due to covid and various international conflicts like the Ukraine war, PTSD is on the rise in the US and globally. However, it is among the conditions that are still not treated effectively with existing drug therapy. Moreover, even if medications help, they take a long time to show results. Thus, there is a need to find medications that act fast, are effective, and are safe for managing the condition.

Researchers are testing many treatments. However, it appears that MDMA (“ecstasy”) and psilocybin (“magic mushroom”) are now among the most promising remedies. These remedies appear to act fast and are especially good for managing PTSD when combined with psychotherapy. A recent study regarding their promising role in PTSD management has been published in the journal European Neuropsychopharmacology. 

These therapies are not to replace psychotherapy. Instead, they work better when combined with them. Psychological counseling remains the most effective and safe way to manage PTSD. However, combining it with MDMA or psilocybin may result in significantly better results.

It appears that due to some inherent qualities, some people are prone to PTSD. Those affected by the condition develop severe issues like nightmares, intrusive thoughts, mood swings, avoidance, and various other physical and emotional reactions. In addition, they sometimes find it difficult to control these physical and emotional responses, causing significant disability. 

Researchers say psychotherapy remains the treatment of choice, as it is the only way to rewire their brains. However, psychotherapy is a prolonged and often quite expensive process. In addition, it means that using it on a massive scale is quite challenging. 

Of course, there are many other drugs in development. However, researchers say that MDMA and psilocybin are among the most promising agents. Here it is vital to understand that these drugs mainly work by increasing the action of psychotherapy and not due to their hallucinogenic properties. They may help individuals become more receptive to psychological instructions. In addition, they ensure better and faster brain rewiring. 

Researchers have already done 4 larger clinical studies. In all the studies, they found that combining psychotherapy with psychedelics was better than psychotherapy alone1.

Of course, “ecstasy” and “magic mushroom” are still the substance of abuse. Thus, their use in medicine is not legal. However, now things are changing fast, as regulatory agencies realize their benefits in PTSD. Hence, it is expected that MDMA may get approval for managing PTSD in a couple of years.

Clinicians are very excited about the perspectives of MDMA approval for clinical use, as they think that it will revolutionize PTSD treatment. Not only that, but it will also open doors for testing these therapeutic approaches in other mental health conditions. For example, there is already sound evidence that psychedelics are quite good for managing depression when used along with psychotherapy.

If approved, doctors will have a potent tool in their hands to rewire patients’ brains. 

Moreover, it is worth understanding that MDMA was created by a pharmaceutical company a long time ago. However, when it was created, doctors tested it for other health conditions, in which MDMA did not work well. 

Additionally, it appears that doctors and regulatory agencies are now changing their attitudes toward MDMA. Though its uncontrolled use may pose a health risk, when used under medical supervision or in the clinics, it is a highly safe way to manage various mental health issues.

 Summary: People do not generally associate mental health disorders with infectious diseases. However, studies show that the brain regulates infection and inflammation in multiple ways, including neuroendocrine responses and even behavioral changes. Studies also show that severe conditions like sepsis are associated with a higher risk of anxiety, PTSD, and other mental health disorders. However, to date, researchers do not know the underlying mechanism. The new study suggests that activation of neural circuits like the bed nucleus of the stria terminalis and the central nucleus of the amygdala play an important role in post-infection anxiety and PTSD.

One does not usually associate infectious diseases with mental health disorders. However, as the new study shows, some severe infections may alter the working of specific brain centers leading to different mood disorders. It would be unwise to think that infections or inflammatory processes affecting various body parts cannot influence mental health. However, one must realize that the brain has a say in all body activities and regulates immune responses.

Sometimes, more severe infections may cause dysregulation of brain function in multiple ways. Science has just started to understand the way in which the brain regulates localized and systemic inflammation. There appear to be two ways the brain can detect and control inflammation. First is the humoral pathway. It means that some of the circulating inflammatory mediators can enter the brain. Thus, the brain can sense inflammation and its severity and initiate a response accordingly.

The second way is a neuronal pathway. Sensory afferent fibers send a signal to the brain, including information on local inflammatory conditions, and then the brain can regulate things. Just take an example of the Vagus nerve. It can detect even the minutest inflammation in the gut and lungs. Once the brain has received humoral and neural signals, it can initiate regulatory responses that involve neuroendocrine, neurovegetative, and behavioral responses. Among neural pathways, autonomic nervous and limbic systems play essential roles in these regulatory responses.

An example of neuroendocrinal response is the release of cortisol, which is a stress hormone. Cortisol is quite good at regulating inflammation. Similarly, behavioral changes also help regulate inflammation. Thus, changes in mood, appetite, and sleep all play an important role in inflammation regulation.

All the behavioral changes aim to regulate inflammation. However, sometimes, the body may fail to initiate optimal responses, which may cause mood dysregulation and increase the risk of psychological disorders. One of the conditions in which there is much risk of inadequate body responses is sepsis. It is a severe and disseminated infection. It causes severe immune response and inflammation. Sepsis is among the leading causes of mortality globally, as it is highly challenging to manage with antibiotics.

Since sepsis is a life-threatening condition, it means that the brain’s responses to the condition are also massive. However, now studies suggest that these responses may cause severe damage to mental health, leading to chronic anxiety, depression, and even other mental health issues. PTSD is another common result of a severe and prolonged infection like sepsis.

Although doctors know that sepsis increases the risk of anxiety, PTSD, depression, and other mental health issues, they do not know how to reduce this risk as little is known about the underlying mechanism.

In one of the first kinds of studies published in the journal Brain, researchers tried to understand how infection and inflammation might cause mental health issues. In the experimental study, they induced sepsis in mice. They found that after two weeks, these mice developed anxiety. They also found signs that resemble PTSD.

In the study, they could identify changes in specific neural circuits like the bed nucleus of the stria terminalis but, more importantly, in the central nucleus of the amygdala. This study is one of the first to identify changes in neural circuits related to anxiety and PTSD post sepsis. These findings can form the basis for further studies into the subject.

Understanding how sepsis or severe inflammation causes mental health & depressive mood disorders may help find effective preventive measures and telehealth treatment. These findings are especially important, as neuroinflammation and resulting psychiatric disorders are also found in those affected by Covid-19.

Summary: PTSD is quite a common problem managed both with the help of medications and cognitive behavioral therapy. Among drugs, doctors mainly use antidepressants to treat the condition. Although most may benefit from treatment, it has a high relapse rate. To reduce treatment duration and prevent disease relapse, researchers need to understand the underlying mechanism of PTSD and find new medications. New studies show that modulating NMDA receptors may help erase traumatizing memories and help achieve spontaneous disease remission. Currently, using ketamine along with cognitive therapy is one way of doing so. In the new study, researchers tested the new molecule NYX-783 with great success.

An estimated 3.6% of US adults are living with PTSD. In addition, it is estimated that about 7% of adults would be affected by PTSD during their lifetime.

PTSD as a diagnosis is not old, and doctors first started using this term to describe mental health issues in Vietnam war veterans. Thus, doctors first defined PTSD in the 1970s. However, it does not mean that PTSD does not exist in olden times.

PTSD has always existed. It is caused by some traumatic experience. Some individuals find it hard to forget those experiences and report trauma symptoms like flashbacks, anxiety, and negative cognitive performance.

One of the issues with mental health disorders is that they are pretty difficult to treat. This is because the researcher still does not fully understand their pathogenesis (how the disease develops and underlying mechanisms). Moreover, modulating specific parts of the brain is even more challenging. Nonetheless, research is ongoing, and we can expect the introduction of safer and more effective therapies in the future.

At present, doctors use a range of drugs to manage post traumatic stress syndrome. They especially use antidepressants like selective serotonin reuptake inhibitors (SSRIs).

A combination of cognitive behavior therapy and drug therapy may help in spontaneous recovery

Along with drug therapy, doctors also use non-pharmacological means to manage the effects of PTSD. People living with PTSD are sane, and thus they can follow the instructions. Hence, cognitive behavior therapy may help desensitize individuals and help erase fearful memories.

Of course, non-pharmacological treatment is better in many ways. In many cases, it has a higher safety profile and may ensure prolonged disease remission or even complete cure. But, non-pharmacological & telehealth treatments like cognitive behavior therapy need much effort and time. Moreover, it fails to help in almost half of the cases. It means that its efficacy can be increased by combining it with some medications.

There are many ways of erasing these fearful memories faster, like using ketamine. However, researchers are looking for more effective and safer drugs.

Studies show that glutamatergic neurons play an important role in PTSD development. Further, studies suggest that the N-methyl-D-aspartate receptor (NMDAR) on these neurons helps control learning, memory, and synaptic plasticity. It means modulating these receptors could be a key to faster PTSD recovery.

Researchers tested a new molecule that may help erase traumatic stress & fearful memories and thus, treat PTSD

In the new study published in the journal Molecular Psychiatry, a team of researchers tested a new molecule called NYX-783 in a mice model. It means that this is still an early study or pre-clinical study. Nevertheless, they found that this particular compound could modulate NMDAR and thus can help modulate memories and early experiences.

The researchers carried out a test by exposing mice to severe and prolonged stress to induce PTSD-like conditions in them. Next, they started treatment procedures aimed at erasing those traumatic memories.

They tested the NYX-783 drug along with ketamine. The researchers found that injecting the new substance about an hour before starting fear extinction therapy could help quite well. The new drug was especially good at inducing spontaneous recovery. It also helped prevent treatment relapse, thus the return of PTSD.

The researchers further studied how this particular molecule works and found that it helps in multiple ways. First, it modulates NMDA receptors by action on the so-called GluN2B subunit. However, their drug activity diminished if they used the Grin2b knockdown model.

Researchers found that although this molecule helped erase traumatic memories, it was dependent on a brain-derived neurotrophic factor (BDNF) to work. Thus, the molecule was less effective in those with suppressed BDNF activity.