Journal of Psychoactive Drugs
January 1, 2019
Anne C Wagner, Michael C Mithoefer, Ann T Mithoefer et al.
92 citations
Combining Cognitive Behavioral Conjoint Therapy for PTSD (CBCT) with MDMA-assisted psychotherapy in a small pilot trial can reduce PTSD symptoms and improve relationship satisfaction. A case study of one couple with a severe trauma history, representative of the trial participants, details the integrated methodology and the couple's treatment experience. The article describes how these two therapeutic modalities were merged and demonstrates that the combination produces positive outcomes, including symptom reduction and enhanced relationship functioning.
European Journal of Psychotraumatology
December 7, 2020
Candice M Monson, Anne C Wagner, Ann T Mithoefer et al.
90 citations
A small pilot study tested whether adding MDMA to cognitive-behavioural conjoint therapy (CBCT) for PTSD is safe and effective. Six couples, where one partner had PTSD, completed a condensed 7-week CBCT protocol that included two sessions where both partners received MDMA. No serious side effects occurred. PTSD symptoms improved substantially, as rated by clinicians, patients, and partners (effect sizes d = 1.85–3.59). Patients also showed improvements in depression, sleep, emotion regulation, and trauma-related beliefs. Relationship adjustment and happiness improved for both patients and partners (d = 0.64–2.79). MDMA may enhance CBCT's benefits for individuals with PTSD and their partners.
Journal of Affective Disorders
August 1, 2023
Richard J. Zeifman, Anne C Wagner, Candice M Monson et al.
56 citations
In a double-blind randomized controlled trial comparing psilocybin therapy (two 25 mg sessions plus daily placebo for six weeks) with escitalopram (two 1 mg psilocybin sessions plus 10-20 mg daily escitalopram for six weeks) among 59 individuals with major depressive disorder, reductions in experiential avoidance mediated improvements in well-being, depression severity, suicidal ideation, and trait anxiety only in the psilocybin group. Exploratory analyses indicated that these improvements (except for suicidal ideation) occurred serially through increased connectedness. Experiences of ego dissolution and psychological insight predicted reductions in experiential avoidance. The findings support reduced experiential avoidance as a mechanism underlying psilocybin therapy's positive outcomes.
Frontiers in Psychiatry
January 1, 2021
Anne C Wagner, Rachel E Liebman, Ann T Mithoefer et al.
40 citations
Healing from trauma happens in relationships, and PTSD affects more than just the diagnosed individual. In a pilot trial of Cognitive Behavioral Conjoint Therapy (CBCT) for PTSD combined with two MDMA psychotherapy sessions, six romantic couples where one partner had PTSD showed improvements across multiple areas. Both partners reported increases in post-traumatic growth, relational support, and social intimacy. Partners also reported less behavioral accommodation and conflict, while patients with PTSD reported better psychosocial functioning and empathic concern. These gains lasted through a 6-month follow-up. The findings suggest that combining CBCT with MDMA can improve relational and growth outcomes, supporting a dyadic approach to holistic trauma recovery.
PLoS One
January 17, 2025
Shakila Meshkat, Wendy Lou, Rakesh Jetly et al.
10 citations
A new pilot study will test whether a single 25 mg dose of psilocybin combined with one week of massed cognitive processing therapy (CPT) is feasible, tolerable, and effective for chronic posttraumatic stress disorder (PTSD), which affects 3.9% of the general population. Fifteen participants with chronic PTSD will receive 12 CPT sessions, two psilocybin-related psychotherapy sessions, and one dosing session over 7 days. Feasibility and tolerability will be measured by recruitment, withdrawal, data completion, adherence, and adverse events. Preliminary efficacy will assess reductions in PTSD severity and explore mechanisms of change, with 12 weeks of follow-up and wearable device data. Results will guide a future large-scale randomized trial.
European Psychiatry
January 1, 2026
Shakila Meshkat, Qiaowei Lin, Rachel Sousa-Ho et al.
Control groups in psychedelic-assisted psychotherapy trials show substantial symptom improvement, likely due to non-specific factors such as expectancy and concurrent psychotherapy. A meta-analysis of 14 randomized controlled trials (643 participants) found that treatment groups had greater symptom reductions than control groups for depressive symptoms, PTSD symptoms, and anxiety symptoms. For PTSD, inactive placebo groups showed larger within-group improvements. The findings underscore the need for robust control conditions and careful interpretation of treatment effects in psychedelic research.
Psychedelic Medicine
April 28, 2025
Shakila Meshkat, Howell Fang, Rachel Sousa-Ho et al.
Low-dose psilocybin, given as 1–3 mg or 0.1–0.2 g of dried mushrooms, shows limited and inconsistent evidence for treating mental disorders. In two randomized controlled trials for treatment-resistant depression, 18% of participants receiving 1 mg showed a significant response, 8% achieved remission, and depression scores improved by −5.4 points at week 3, but only 10% maintained improvement by week 12. Another trial reported no significant improvement with 1–3 mg, though 12% achieved anxiety remission and 16% depression remission. A trial comparing 25 mg to 1 mg plus escitalopram found higher response rates with the higher dose. The evidence is constrained by few well-designed studies comparing low-dose psilocybin to placebo.