February 2022, ScientificAmerican.com 57Maurice MikkersI
n the spring of 2017 i was serendipitously
invited to what initially seemed to be the
wrong scientific meeting. The invitation
came thirdhand, and the details were
murky but intriguing. I took a car to a
train to a downtown hotel where I wound
my way through a series of conference
rooms before a sign on a door made it clear
that something was terribly wrong. It said,
“MAPS Phase 3 meeting.”
Phase 3 is the final step in clinical drug testing before ap-
proval. It is conducted with a large group of study volunteers to
make sure a drug is safe and effective. The endless meetings sur-
rounding these trials typically involve months of vetting, confi-
dentiality agreements and contracts; they are not to be crashed
by wayward scientists with thirdhand invitations, and I imme-
diately felt out of place.
Before I could retreat, someone emerged from the confer-
ence room and looked me over intensely. She asked me to ex-
plain myself, and then, to my surprise, she turned to staff at the
check-in table and said, “Get her a name tag. We’ll figure this
out later.” By the end of the day I had come to know this power-
house by name: Berra Yazar-Klosinski, chief scientific officer at
the Multidisciplinary Association for Psychedelic Studies
(MAPS). My background in behavioral pharmacology and clin-
ical trials seemed to pique her attention, and by the end of the
meeting I had committed to working with her on the phase 3
program that would assess the efficacy and safety of MDMA—
known recreationally as Molly or Ecstasy—for severe PTSD, or
post-traumatic stress disorder. PTSD is characterized by the re-
living of unwelcome traumatic memories, and according to the
National Center for PTSD, upward of 15 million people in the
U.S. suffer from this debilitating condition in any given year.
MDMA, short for 3,4-methylenedioxymethamphetamine, is
an amphetaminelike compound that was first developed by Eu-
ropean pharmaceutical giant Merck in 1912 as part of a research
program on blood-clotting agents. Shelved for years, it was resyn-
thesized by chemist Alexander Shulgin in the 1970s and immor-
talized in his book PiHKAL, which contains a recipe for MDMA.
Not long after, Shulgin shared the compound with a friend, psy-
chologist Leo Zeff in Oakland, Calif. Zeff and his colleagues be-
gan to use MDMA in conjunction with psychotherapy in private
practice and noted that their patients were better able to confront
emotionally evocative and distressing memories. Within an hour
of ingesting the compound, patients could set aside their fears
and face recollections of shame and trauma.
Right on the heels of this discovery, however, MDMA stepped
out of the psychotherapist’s office and barreled into general cir-
culation, becoming one of the most used substances for recre-
ational purposes of the 1980s. In 1985 the U.S. Drug Enforce-
ment Agency (dea) classified MDMA as a Schedule I substance,
making its possession a crime punishable by up to 15 years inPSYCHEDELIC
CRYSTALLIZED MDMA imaged through a polarized light microscope.