A collaborative working relationship has been established between MAPS, psychiatrist Dr. Evgeny Krupitsky in St. Petersburg (Leningrad) and the psychiatrists working on the MDMA protocol here in the US. The catalyst for this working relationship was the presence of four psychiatrists and a translator from Moscow at the MAPS international psychedelic research methodology conference in Switzerland. Dr. Krupitsky writes that he has "discussed again the possibilities of MDMA research with Drs. Rzhankova and Dunaevsky from the Leningrad Institute of Oncology, Academy of Medical Sciences of the USSR. They informed me that maybe it will be possible to receive permission for this work from the Pharmacological Committee of the Ministry of Health, especially for the last draft of the protocol with the accent on the relief of pain, because of the large amount of substances with high addictive potential (narcotics) that are tested and used in oncology for the relief of pain. I can't give any guarantee, but we hope it will be successful."
A comparable study in Russia would be much less expensive than one in the US, even though researchers in the US will donate much of their time to the experiment. Dr. Krupitsky writes that "the cost for one patient may be about $700 - $1,000." Research in Russia is of value to MAPS because the FDA will accept one efficacy study from abroad into the MAPS MDMA Drug Master File. This means that international collaboration, particularly in countries like Russia with experienced researchers and relatively low salaries, is definitely the way to get the most out of MAPS' scarce resources.
There will be some differences between the protocols in the US and in Russia due to different political pressures and research objectives. Dr. Krupitsky reports that the use of spinal taps would make it more difficult to gain approval for the study in Russia, since spinal taps are strictly limited to people with certain indications. We need to use spinal taps in the US because of official concern over neurotoxicity. Ironically, a Swiss Institutional Review Board (IRB) also rejected the use of spinal taps in MDMA research, which they felt posed more risk to the patients than the possibility of MDMA neurotoxicity. In addition, Dr. Krupitsky proposes that the Russian control group receive "logical therapy", much like what we call "cognitive therapy", rather than guided imagery and music (without MDMA) as in the US plan.