Magnus: Hello, my name is Magnus and I am from the Autism News NetWORK. Today’s podcast is a little different. Today, I have Dr. Dobson, Dr. Eric Dobson, and Dr. Gwynette here today. We’re going to talk about MDMA slash ecstasy, or as a cool kid say nowadays, “Molly.”

Magnus: Hey, Dr. Dobson, it’s not every day that people talk about MDMA or Molly, and autism altogether. How did you get interested in the psychedelic drug study?

Dr. Eric Dobson: I think the first time I had heard about psychedelics as being used for a therapeutic reason, was kind of early on when I was an undergrad up in Columbus, Ohio. One of my dorm mates had mentioned an article they read. Someone had taken Psilocybin mushrooms and had these major personality changes. So that caught my ear, and it was kind of scary. It was like, what’s going on? How can a chemical cause that intense of a reaction in a person?

Dr. Eric Dobson: But reading more and the further I got my medical studies, a lot of the changes that can happen with psychedelic substances, and we’re getting more and more research to support this, are actually positive changes. People being more open, gregarious, better interpersonal relationships. So, always been an interest of mine, and I think over the past 10 years, there’ve just been more and more studies about, not just those classic psychedelics, but also ecstasy or MDMA.

Dr. Eric Dobson: I run a journal club for some of the residents at MUSC and we’re always looking for different areas within psychedelic research to focus on. This was just a really interesting niche to me. And of course, I think an interest to Dr. Gwynette as well. We brought him on for one of our journal clubs a couple of months ago, and that was where we took a deep dive into this subject.

Dr. Gwynette: Yeah, that was cool. It’s a fun thing to say. I think it’s the South Carolina Psychedelic Science Group.

Dr. Eric Dobson: Yeah. You know.

Magnus: I’m just so excited we’re actually moving forward with different alternatives, I would say, to that classic medications that have been out for some time now. [crosstalk 00:02:32] Sorry.

Dr. Eric Dobson: I was just gonna say, I think your sentiments shared by a lot of patients I see, maybe they don’t necessarily have an interest in psychedelic specifically, but there’s a lot of folks that are okay, well there’s therapy. There’s these medications you take every day. But some people, therapy is not enough. And for some people they don’t want to be on a medication every day. So I think that’s a pretty broadly held sentiment you mentioned.

Magnus: Hey Dr. Dobson, what is your training background and where are you from? Where do you represent? [crosstalk 00:03:04]

Dr. Eric Dobson: I’m a Buckeye. I was born and raised in Cincinnati, Ohio and I think not unusual here in Charleston to have some of us Ohioans migrating South here. Went to Ohio State for undergrad. Did my four years of medical school back in Cincinnati… University of Cincinnati. I’m in my third year of four training here as a psychiatry resident at MUSC.

Dr. Gwynette: Have you ever heard of a band called flogging Molly?

Dr. Eric Dobson: Yes, I have. Yeah.

Dr. Gwynette: I always think of that when I hear a Molly.

Magnus: So Dr. Dobson, what is MDMA?

Dr. Eric Dobson: MDMA is a synthetic psychoactive compound. It’s made in the lab. Has both like stimulant qualities and also what I collect in pathogenic qualities. So it can increase empathy and trust for oneself or others. It overlaps with what I think about is like classic psychedelics, like Peyote, Magic Mushrooms or Psilocybin in a lot of ways. And actually its structure is kind of somewhere between Mescaline which is the active ingredient in Peyote and like Adderall or Amphetamine. Typically, lasts about six hours, the acute effects so you do get kind of these stimulating effects, increased heart rate, increased blood pressure, but also kind of a change in how the brain is seeing the self and also seeing others.

Magnus: So it gives you some confidence. I was reading through the study that MDMA increases basically your confidence. Some people may use alcohol. Some, like I said, there’s different alternatives in today’s age. We can only hope to explore what we can, you know?

Dr. Eric Dobson: Yeah. I think confidence is definitely part of it. But it may be even a bigger part is trust. And that’s so important. I mean, when you’re interacting with anyone really, right? You want to be able to trust them. If you don’t trust someone, you might be running the other direction, but especially working with a doctor or therapist, trust is just so, so important. Yeah.

Magnus: I hear you. Oh man, what is, MDMA usually famous for? I know what it’s famous for. It was ecstasy before. The term has been changed into Molly. It’s a party drug… A rave. That’s what it is. Most people… That’s where the term comes from and the music and everything. The younger generation exploits the positive parts of the medications.

Dr. Eric Dobson: You bring up a really important point. When MDMA was for synthesize, it’s sort of have been like in the 70s. It was probably first used in therapeutic settings. So it wasn’t illegal at that point. It was just a chemical. And there were a good number of therapists, psychiatrists across the country that were trying to somehow integrate this powerful chemical into their clinical practice. But then it kind of escaped the lab, escaped the clinical situation. A lot of the effects of MDMA blend really nicely with what people would like out of a night at the rave. So they’re gonna want to stay up all night. They’re gonna want to have more energy. They’re gonna want to interact more closely with other people. But a lot of bad came from that too. A lot of using this drug with clinicals.

Magnus: Overheat. [crosstalk 00:06:47] Like one of my favorite movies, Bad Boys. That was one of the plots of the first one. Ecstasy and you just see them overheat and just die from it just being overheated.

Dr. Eric Dobson: That’s probably the most common thing. People passing out. You imagine like the rave. It’s kind of hot, people are exhausted. But you’re kind of missing your body’s natural cues that maybe you should be sleeping right now. It can… It has definitely led to some bad outcomes in rare cases, even death.

Dr. Gwynette: I didn’t realize that it was used decades ago in clinics. Before, you said it escaped from a lab type of thing.

Dr. Eric Dobson: It’s really interesting. The guy who popularized it, Alexander Sholgin, he probably made upwards of a hundred different psychoactive compounds. And again, I guess he can’t really make it legal, what doesn’t exist yet. These things kind a grace period of maybe 10 years where they circulated. They were like these networks of different therapists and psychiatrists that would share this drug that was being used as a medication. It was like the Wild West. It was being used not just by one or two therapists, but by a lot of them.

Dr. Gwynette: Really interesting.

Dr. Eric Dobson: That kind of built on earlier psychedelic assisted psychotherapy. The sixties that was mostly used like…

Dr. Gwynette: The Hippie movement.

Dr. Eric Dobson: Hippie.

Magnus: We’ll just call it as it is.

Dr. Eric Dobson: That was a good 20 years before ecstasy was big. So this was a second wave of psychedelic assisted psychotherapy with MDMA.

Dr. Gwynette: I guess this is getting into a really important point. We’re probably going to touch on later is that something originates in the lab in the clinics and then it kind of escapes from the lab and then 28 days later, or whatever, you’ve got people using doses that are maybe multiple of what is tried in research settings and they’re using it, like you said, not reading their body’s cues, not monitoring vital signs, not monitoring fluids. And certainly things can go South from there. The study we’re going to talk about later, they’re really paying a lot of attention to dosage, the administration, medical support, psychiatric observation, so that’s I think something really important to point out to the audience as we proceed on our discussion.

Magnus: Yes. Actually my next question is how is this drug made, like the whole procedure of just trying to get it going.

Dr. Eric Dobson: Really good question. Interestingly, the specific chemical that was used for this study… This is the… Let’s see. I think it was 2018 Danford Study probably was synthesized in 1985. At a lab in Purdue, David Nichols was the guy who synthesized this original batch of MDMA. And it was probably a lot easier to synthesize before 1985. Because after that it was schedule one, it was a controlled substance. So there was this supply that was created. It was relatively stable, relatively pure. It was being used in a lot of phase one, like this study in phase two clinical trials. And just recently this came up again because for different population, for folks with PTSD, MDMA just completed a phase three or that’s the last one before approval in clinical trial. And for that specific study, that was a big one.

Dr. Eric Dobson: The FDA required like any drug that’s seeking approval, that it be made with good manufacturing practices or GMP. So the folks sponsoring the trial had to find a lab that both was okay, synthesizing a schedule one drug legally, could synthesize a schedule one drug, which requires a special license and then could do it up to the standards of the FDA. And so it was like a year’s long search to find a lab that would do this. They ultimately did find one. But that’s all happening after this study. This one, I think as best as I could tell was from this batch that was way back from 1985.

Magnus: Oh, wow. So it’s been some time now. So why do you… Why are you doing a study? What are you looking to get out of it? How can this help individuals with Autism?

Dr. Eric Dobson: I mean, that’s the big question, right? Like why do the study in the first place? And I think what MDMA brings to psychiatry is really a few different things. But the biggest of it is just increasing that trust and Alliance that happens between a patient and a therapist. And so, especially when you’re talking about something like social anxiety in someone with Autism, that can be a barrier that’s kind of hard to overcome. It can be hard to form that connection with a therapist. The whole point that a person with social anxiety is in treatment is to get over their anxiety about being around other people. So this is a huge catalyst for building that trust rapidly, and then unlocking social skills of decreasing social anxiety from there.

Magnus: One of the problems with myself is we can’t be around people. We end up losing them as friends because of what we say. We just don’t think before we say it. That’s just me, but yeah, definitely. You know, it’s the anxiety that gets to me.

Dr. Eric Dobson: Yeah. I would imagine. Part of that leads to kind of less trust of other people, or maybe even less trust of yourself. If you run into times where, Ah, darn I wish I wouldn’t have said that. People with social anxiety could be kind of like hypercritical of themselves. They can really get down on themselves too much. And that can lead to an unhealthy place for a lot of people.

Magnus: Oh yeah. That’s so true.

Dr. Gwynette: There’s something I picked up like in our autism News NetWORK group. Like this morning on our group meeting, we had legitimately 15 participants. They all are adults with autism and we’re trying to make that a cohesive group. And sometimes it can be challenging when everyone in the room has significant anxiety and Autism symptoms. The default is that group is going to be pulled apart by the social deficits and the communication deficits. And as you mentioned, Magnus, yourself that the Autism News NetWORK is a program, but more than that, it’s a community, right? So we’re actually trying to overcome the social anxiety and the social deficits every day and stick together.

Magnus: Yep. This is one of the good things… one of the many great things. Dr. Dobson, what are the risks with this drug? I know the risk for anything in life, but what are the risks for this one?

Dr. Eric Dobson: MDMA is, I would say, a reasonably safe medication, as best as we can tell from the trial so far in a very controlled environment. But even in that environment like Dr. Gwynette mentioned earlier, there’s a lot of monitoring that takes place. So it’s a stimulant. It can increase heart rate, blood pressure, body temperature, and those things were all monitored throughout the trial. And this trial I think, it’s in the fine print there, but they excluded a lot of people with medical problems.

Dr. Eric Dobson: They excluded folks with diabetes, glaucoma, high blood pressure, history of seizures, liver disease. And then not just physical problems, but also either family history of psychiatric problems or personal history. They excluded folks with relatives with bipolar disorders, schizophrenia, folks with dissociative identity, eating disorders, suicidal thoughts. So this is a very carefully selected sample in this study. And then when we’re talking about outside of this clinical setting, all those risks are just amplified. You mentioned earlier, this common stereotype of people taking ecstasy and raves. It’s a hot place. Hyperthermia is only going to get worse. People can drink too much water, not enough water. They can have fluid imbalances, seizures…

Magnus: Not only that. But they’re drinking alcohol as well. If they’re in a club, they’re definitely drinking alcohol.

Dr. Eric Dobson: Great point. Great point. Nobody in this trial is drinking, right? So we don’t have the good data. But you imagine the more substances on board, the higher the risk. Alcohol, Cocaine, Cannabis, all these are kind of wildcards that can lead to a lot more problems, even though this trial looked like it was safe in these specific conditions. People often just don’t know what they’re taking, if you have a white powder or a tablet. There actually been studies that look at the purity of these things and people run into two problems. One is what they think is MDMA, isn’t even MDMA. It’s Methamphetamine. It’s any number of other synthetic drugs or the dose of the drug is way more than they expect. It’s two or three times more potent than they expect, which as you can imagine, would lead to a lot of problems.

Magnus: I honestly… I think in today’s age, we kind of do have that problem with our youth. We definitely have a problem. So in five years, do you think the MDMA will be prescription only, or just strictly under just a study research in South Carolina?

Dr. Eric Dobson: Yeah. I think when change comes, it’s going to be probably nationwide. You hear about ballot initiatives sometimes for like Psilocybin, some for Cannabis where it’s like different counties, different States are legalizing recreational use or medicinal use of all these different substances. For MDMA the most likely thing that’s going to happen in the next five years is probably within the next two or three years, there’s going to be still another phase three clinical trial, probably for MDMA in treating PTSD that could lead to FDA approval. And there’s actually already been a motion approved the FDA to fast track that approval process because of the promise of this treatment. So more than likely, maybe 2023, 2024, you’re going to see this as an FDA approved medication, then it would probably be rescheduled by the DEA.

Dr. Eric Dobson: It would be kind of a least restricted, maybe schedule two or schedule three substance rather than it’s currently a schedule one substance without accepted medical use. So once that happens, the question is, okay, so it’s legal. It can be prescribed. What happens now? More than likely, this won’t be something you can go to your pharmacy fill, take home and use. It’ll probably be dispensed in a specific clinical environment along with at least supportive Psychotherapy. And then the question for there is how do we make it affordable, accessible? You don’t need to be approved by insurance companies. We’ll have to work on how to deliver at a cost-effective and sustainable way. But that’s all down the road. In the next five years, I think it is likely that this will be a prescription medication.

Magnus: So doctor… Oh man, I’ve always wanted to ask this. Dr. Dobson, do you… Not specifically MDMA but other psychedelics, do you think they can potentially unlock a person’s mind and just… You see, you get new technology. You don’t… You’re not in this realm. You just see stuff that it’s just not for the normal human being… brain to handle. It’s just too much.

Dr. Eric Dobson: There’s long been this question of creativity and psychedelics. Is there a connection? And I think Steve Jobs was a big and the founder of Apple.

Magnus: There was Darwin as well. I learned that one from Joe Rogan. Yes, sir. Charles Darwin as well.

Dr. Eric Dobson: Oh okay. And even the Francis Crick who was kind of discovered the DNA Double Helix. There are a handful of these scientific figures who have said, I used LSD or I used mushrooms and I was able to think more creatively. So great question. There actually are some trials that basically study just that. A dose of Psilocybin mushrooms given to either artist or scientist. And then they look at them the next few weeks and see if they’re having more creative insights, things like that. They found that there was a signal for that. There is more creative thinking after taking a psychedelic. Then a lot of people are looking more into like micro dosing or taking very low doses on a more frequent basis. I think the jury’s more still out on that. I don’t think there’s a lot of great data and even the stuff with these larger doses are really early data, but there’s reason to think there’s something to that.

Magnus: Oh yes. Definitely. If you look into a lot of ancient religions, hallucinogenics were around then. The peace pipe, I don’t think that was tobacco or marijuana to tell you the truth. I don’t know, man. A lot of ancient religions you say, eat a psychedelic and just free your mind. Just learn the way, the tribe, the people, their history. It’s deep. I learned all these from the… I don’t know if you’re familiar with… Of course, you know, Joe Rogan. Everyone knows Joe Rogan. And what Joe Rogan likes to talk about all the time is DMT. I just started listening and how he would describe how it just opens your mind. You just… I think you will only operate a certain percentage of your brain.

Dr. Eric Dobson: Yeah. Joe Rogan, I would say, I know of him. I don’t think I’ve watched and maybe a clip here and there, but I didn’t do know he’s a big fan of DMT, which is just an interesting topic all on its own. It’s… DMTs similar to the active ingredient in magic mushrooms, but it’s super short acting. It’s like 30 minutes or even less. It’s not something we’ve studied clinically before. But it has been studied in humans… healthy humans without any sort of depression, anxiety, things like that back in the nineties. It brings up a really interesting point. If psychedelic mushrooms are proven, safe and effective for depression, will they last six hours? LSD lasts more like 12. Can you get the same effect from a 30-minute session? That would be a huge game changer. Can it unlock your mind? There’s getting to be more and more kind of like neuroimaging research to show. What does that mean, unlock your mind? What’s actually going on in the brain? It’s really interesting. Really exciting time.

Magnus: I just feel like if you give the proper… just the right person, they’re going to unlock some new technology or some time traveling. Some real… actual time… we have some time travelers.

Dr. Eric Dobson: I think it’s hard to know what we don’t know, in a way. And certainly there’s people throughout history. You mentioned a few of them already who would swear by psychedelics. There’s some people that would swear by it and not actually have the Apple level Steve jobs, body of work to stand by it. I think there’s reason to believe that in the right hands, a lot of good could come from psychedelics.

Magnus: Hey, Dr. Gwynette…

Dr. Gwynette: Yeah…

Dr. Eric Dobson: What else can we add?

Dr. Gwynette: Well, I was going to add a question. I was listening… might have been a podcast, an author talking about the writing process, and I can’t remember who the author was, but they summed up writer’s block as basically being fear. The book is inside someone’s head, but the fear of putting it down on paper and not having it be good is writer’s block. That fear of getting started, fear of failure. I wonder sometimes with social anxiety, because that can be so common with people with social anxiety. If agents, like MDMA might remove a bit of the anxiety and increase the trust just enough so that it can unlock, as you said, Magnus, unlock skills and talents that are…

Magnus: Unlock your full potential.

Dr. Gwynette: Yeah.

Magnus: And Dr. Gwynette, I don’t know if you noticed , but my previous doctor to you was Dr. McLeod. I stated, Doug, man, something’s wrong… I didn’t know I was Autistic at that time. I said, Doug, man, I feel like there’s potential to be unlocked in my brain, but I can’t access it. I’ve said this for years. I’ve said this for years. I think there’s a barrier just blocking information to my brain.

Dr. Gwynette: Yeah. And I didn’t know if Dr. Dobson, if you felt like that concept of removing anxiety as a barrier to creative creativity or productivity sometimes is a concept that we see in the literature.

Dr. Eric Dobson: Yeah. And what you bring up Dr. Gwynette, I think gel’s really well with like the neuroimaging research we have and how that matches up with what we see clinically and subjectively. One of the main ways that most of these psychedelics seem to work is to disrupt something called the default mode network. This is the network in the brain that the different areas that are connected when you’re not doing any specific task. You’re wakeful alert, but you’re not tasked with doing anything specifically. So what’s your mind doing during those times? You might be daydreaming. You’re thinking about yourself. You’re thinking about the past, the future. You might be thinking about what will happen if someone comes up to me and starts to talk with me, kind of social anxiety. For sure, with depression, this network is really overactive.

Dr. Eric Dobson: That’s one of the ways we think psychedelics might work for depression is disrupting this network that is kind of this ruminative network that people can kind of get stuck in. Now, the changes we see when people kind of become more creative after using a psychedelic also seem to be tied to this default mode network, breaking out of this rigid, ruminative state. So I think that there is support for that in the literature. I don’t know that neuroimaging has been done in these social anxiety trials specifically, but it seems to phenotypically or how it looks match that kind of rumination that you see with depression.

Dr. Gwynette: That’s really well said. It’s exciting. I just also want to just make a quick comment that everything we’re talking about here… The research is being conducted by very serious scientists and physicians under controlled situations where they’re monitoring the dosage, how it’s administrated. I think a cynic might say, this is not about making patients trip out on drugs and hope for good results. This is a very intentional, calculated, with safety as the highest priority, really, and then once the safety ranges have been established, then looking and trying to establish evidence that it can be helpful in a clinical setting. I think it’s exciting because in Autism, we don’t have biological treatments for autism period. So there are no FDA approved interventions from a biological standpoint. That’s medications or other procedures that can be helpful for core symptoms. I consider anxiety almost like a core symptom for Autism. With you Magnus, were it so common?

Magnus: It was. It sucks, honestly. A normal person, there’d be out, just chattin’ at a bar. Me? I’d rather be home, just alone, just chatting online. That’s how you know, it was just bad.

Dr. Gwynette: Yeah. And then in your life, you’ve been really open about anxiety and trying to overcome that. As I mentioned, every Thursday, when we have our big meeting, we all know it’s there and we fight through it. And this intervention that we’re learning about today, maybe useful for adults with Autism and social anxiety. So it’s really exciting that people are doing this work.

Magnus: I would have to agree Dr. Gwynette. As an adult now, if there’s something that can help me in life, I’m probably going to look into it because life is already hard as it is.

Dr. Gwynette: And I’m wanting to give you a shout out, Magnus because what you’re doing today, on this show, is phenomenal. You’re sitting here, talking about some really cool literature… scientific literature with a couple of docs and you’re holding your own. It’s great. So well done.

Magnus: Oh yeah. Doc, I’m always improving… always improving. If you look through our earlier productions, you can tell there’s some quality control update… updates.

Dr. Gwynette: Yeah. Magnus Dr. Dobson listened to your blockbuster pod.

Magnus: Oh, what’d you think of it?

Dr. Eric Dobson: Oh, it was great. It brought up… I was in my car. I listened to it and it was… brought back a lot of fond memories. I was… You were talking about the scent of blockbuster and I couldn’t quite place it, but I almost wished there was like it in a bottle or something. So I could just be, okay, yeah, that’s it. Because I’m sure my nose would recognize it. But yeah. It brought back a lot of good memories.

Magnus: Yeah, man, blockbuster, man. An ancient relic now… It’s an ancient relic. Nobody uses DVD, VHS. Everything is just bought on Amazon. But the thing is, they can take it away. This is why I prefer physical copies of items easily, any day now. Always have a physical copy.

Dr. Gwynette: Yeah. Netflix now is posting on the… At least my screen will say this goes off Netflix, May 31st. Because that’s one of the things like, oh my gosh, it’s gone.

Dr. Eric Dobson: I think their last one was in Alaska is what I heard at least.

Magnus: Yeah. I bet you they’re making money too. I bet you. People just want to just go in there just for old time’s sake. [crosstalk 00:30:52] Like it’s like it’s at the Alamo.

Dr. Eric Dobson: Right. Yeah. The last one, the last one. I know a lot of good memories that makes you want to go to Alaska and visit that one.

Dr. Gwynette: Yeah. Well this has been so fun. Dr. Dobson, if you don’t mind, can you tell us about how people can learn more about the South Carolina Psychedelic Science group?

Dr. Eric Dobson: Oh wow. You know what dr. Gwinnedd? You bring up an awesome point, which is, I don’t know that we even have an internet presence. I don’t know if we…

Magnus: Oh man. That’s that’s a problem, man. It’s 2021.

Dr. Eric Dobson: Yeah. I’ll say this. I’ll say this. If anyone’s interested, they can always email me and my email. You can reach me at, at E-R-I-C-D-O-B-S-O-N.55@gmail.com. I think that’d be the best way failing. There’s no Instagram. There’s no nothing, but maybe, that needs to change in the future.

Dr. Gwynette: Well thank you for sharing that. I mentioned… Magnus, I mentioned to Dr. Dobson. He’s got a great voice, doesn’t he, Magnus?

Magnus: Yes, he does.

Dr. Gwynette: I think he was born to pod. So hopefully we can have Dr. Dobson back on the show again soon, because this was really fun wasn’t it, Magnus?

Magnus: Oh man, it was great, man. I felt like Joe Rogan for this podcast. I’ve always wanted to ask these type of questions. Hey Joe! If you’re listening, you hook me up, man. Seriously, hook me up. At least… or the group.

Dr. Gwynette: For sure. Come on, Joe, show us some love, man. At least retweet us when we put this out there. All right guys. Well Magnus, do you want to take us out?

Magnus: And that is how we’ll… we will be ending the podcast today… the very interesting podcast we had. Thank you and have a great day,

Dr. Gwynette: All right. Thanks to Dr. Eric Dobson from MUSC department of psychiatry and behavioral sciences. Dr. Dobson. We hope to see you again soon. All right. Thanks so much for having me. This. This has been a lot of fun. Thank you.