Did boundary violations sync MDMA assisted therapy, or was there something more?

In part two of our series, we look at what else went wrong.

Welcome to the Carlet Psychiatry Podcast, keeping psychiatry honest since 2003.

I'm Chris Akin, the editor-in-chief of the Carlisat Psychiatry Report.

And I'm Kelly Newsom, a psych-n-p, and a dedicated reader of every issue.

First, an apology.

We announced in the paper journal that we'd feature an interview with Kyle Greenway on

Catamine-assisted

therapy last week in our June 10th podcast. That has been moved to June 24 to make room for the

breaking news on MDMA. This month, an FDA panel voted to reject MDMA-assisted psychotherapy

for PTSD. That doesn't mean the case is closed.

The panel is an independent group of 11 scientists, clinicians and patient advocates who advised the

FDA. The FDA will make their final decision in August, and while there's still a chance for

approval, we're not optimistic. 90% of the panel members voted against it, and while there's still a chance for approval, we're not optimistic.

90% of the panel members voted against it, and the agency usually follows their advice.

Sexual boundary violations, which we covered last week, were one of the reasons for the fail. Last year, we warned about this potential in a special issue on psychedelics,

but we didn't anticipate it would happen under the registered eye of the clinical trial.

But that was not the only problem that sank MDMA.

Another was functional unblinding,

which means that even though this was set up as a double-blind trial,

patients and the therapist could usually tell who got the placebo.

Imagine that you sign up for an MDMA trial, and the investigator tells you that you're going to get either MDMA or placebo.

...