Is MDMA effective at treating misophonia?
There has been some misunderstanding about the use of MDMA for treating misophonia and misokinesia.
This stems from this paper: MDMA for the treatment of misophonia, a proposal [November 2022] by Jadon Webb and Shannon Keane [Frontiers in Psychology]
This paper is freely available to read at the link above and is quite clearly written in a manner that is fairly accessible. We recommend that people who are intrigued by this topic read the paper in its entirety.
First, this paper is a proposal, meaning no testing whatsoever has been undertaken on the use of MDMA to treat misophonia. It’s purely speculation based on the current information we have about what happens in brains when misophonia is activated.
In layperson’s terms, the researchers who wrote this paper are matchmaking what we know of the neural mechanisms that are included in misophonic reactions with available medications which are known to affect those mechanisms. This is a common approach to finding pharmacological methods for treating novel afflictions which are just beginning to be understood better.
The paper is stating a hypothesis about misophonia and MDMA. It provides no evidence to suggest that MDMA is effective at treating misophonia, yet.
What this paper is not is encouragement to self-medicate with MDMA.
From the paper:
It is critical to understand that recreational use of MDMA is NOT recommended at all. This is a powerful treatment that must be administered in a safe setting, by a trained medical and psychological professional. The concentration and purity of MDMA used outside of research settings cannot be validated since this still remains a schedule 1 substance. Consuming MDMA recreationally may involve risks such as ingesting impure substances, ingesting excess amounts, and experiencing unpleasant effects in unsafe environments. Before recommending MDMA to people struggling from misophonia, randomized controlled trials with good generalizability are needed for evaluating the effectiveness of this treatment.
While this paper is interesting, it is way too early to make any judgments regarding using MDMA for treating misophonia.
This paper lacks any actual testing, a large sample set, a control group, adjustments for things like placebo effect and other factors. We aren't sure what the long-term outlook would be, and so on.
What is needed is an actual study with many participants which includes the necessary factors I named above, and more. If the results of that much larger study show promise, then it needs to be published and then other researchers would need to duplicate it themselves with a different set of participants. Those results would then need to be critiqued, analyzed, and fine-tuned by other researchers in additional studies.
If, after that process, MDMA shows promise in treating the symptoms of misophonia and the medical community agrees, then that could be very exciting. Any such treatment would need to occur under the guidance of a physician or licensed medical professional. But we aren't at that point yet.
As a person who has struggled with misophonia for decades, I can completely understand how anything that could be a treatment—something, anything that might relieve our suffering and make life more manageable—is notable. But, we also strive be realistic about what is showing up in the research. We have seen many people, with understandably high hopes who are at their wit's end, be disappointed by various claims about misophonia treatments that have been misunderstood or overstated.
It’s nice to see this kind of thought and effort being put into potentially treating misophonia, but there is a long way to go still before any such treatments are shown to be effective.
If MDMA or another medication shows promise, through thorough testing and study, as a possible treatment for misophonia, we will certainly report on this.