MDMA-assisted psychotherapy for PTSD in adolescents: rationale, potential, risks, and considerations.
Samuli Kangaslampi, Josjan Zijlmans
European Child & Adolescent Psychiatry November 1, 2024 DOI: 10.1007/s00787-023-02310-9 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Theoretical or philosophical paper Peer reviewed |
|---|---|
| Population | Adolescents with PTSD |
| Intervention | MDMA-assisted psychotherapy |
| Topics | MDMA PTSD Psychedelic-assisted therapy |
| Keywords | Adolescents Psychotherapy |
| Citations | 18 |
| Key points | Argues that MDMA-assisted psychotherapy holds potential for treating PTSD in adolescents, but clinical trials are needed to determine its safety and efficacy. |
Abstract
3,4-Methylenedioxymetamphetamine(MDMA)-assisted psychotherapy (MDMA-AP) is a proposed treatment for posttraumatic stress disorder (PTSD) that may be approved for adults soon. PTSD is also common among trauma-exposed adolescents, and current treatments leave much room for improvement. We present a rationale for considering MDMA-AP for treating PTSD among adolescents. Evidence suggests that as an adjunct to therapy, MDMA may reduce avoidance and enable trauma processing, strengthen therapeutic alliance, enhance extinction learning and trauma-related reappraisal, and hold potential beyond PTSD symptoms. Drawing on existing trauma-focused treatments, we suggest possible adaptations to MDMA-AP for use with adolescents, focusing on (1) reinforcing motivation, (2) the development of a strong therapeutic alliance, (3) additional emotion and behavior management techniques, (4) more directive exposure-based methods during MDMA sessions, (5) more support for concomitant challenges and integrating treatment benefits, and (6) involving family in treatment. We then discuss potential risks particular to adolescents, including physical and psychological side effects, toxicity, misuse potential, and ethical issues. We argue that MDMA-AP holds potential for adolescents suffering from PTSD. Instead of off-label use or extrapolating from adult studies, clinical trials should be carried out to determine whether MDMA-AP is safe and effective for PTSD among adolescents.
Comparable studies
Other theoretical and historical papers on MDMA and psychedelic-assisted therapy, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| The potential use of N-methyl-3,4-methylenedioxyamphetamine (MDMA) assisted psychotherapy in the treatment of eating disorders comorbid with PTSD. | 2021 | Theoretical or philosophical paper | |
| Couple Therapy With MDMA-Proposed Pathways of Action. | 2021 | Theoretical or philosophical paper | |
| Informed Consent in Psychedelic-Assisted Therapy. | 2024 | Theoretical or philosophical paper | |
| The “Third” Eye: Ethics of Video Recording in the Context of Psychedelic-Assisted Therapy | 2023 | Theoretical or philosophical paper | |
| MDMA-assisted therapy: challenges, clinical trials, and the future of MDMA in treating behavioral disorders. | 2025 | Theoretical or philosophical paper |
Citations in the library
Cited by 9
- MDMA-Based Psychotherapy in Treatment-Resistant Post-Traumatic Stress Disorder (PTSD): A Brief Narrative Overview of Current Evidence Diseases November 3, 2023
- Expert opinions on implementation of MDMA-assisted therapy in Europe: critical appraisal towards training, clinical practice, and regulation. European Journal of Psychotraumatology 2024
- Clinical psychedelic research in adolescents: a scoping review and overview of ethical considerations The Lancet Child & Adolescent Health September 2, 2025
- Leveraging family and caregiver support in psychedelic-assisted therapy: considerations for the treatment of adolescents. Child and Adolescent Psychiatry and Mental Health June 4, 2025
- Therapeutic Potential of MDMA- and Psychedelic-Assisted Psychotherapy for Adolescent Depression and Trauma. Current Psychiatry Reports February 1, 2025
and 4 more in the library
Cites 47
- MDMA-assisted therapy for severe PTSD: a randomized, double-blind, placebo-controlled phase 3 study. Nature Medicine June 1, 2021
- The safety and efficacy of {+/-}3,4-methylenedioxymethamphetamine-assisted psychotherapy in subjects with chronic, treatment-resistant posttraumatic stress disorder: the first randomized controlled pilot study. Journal of Psychopharmacology July 19, 2010
- MDMA-assisted psychotherapy for treatment of PTSD: study design and rationale for phase 3 trials based on pooled analysis of six phase 2 randomized controlled trials. Psychopharmacology September 1, 2019
- MDMA enhances emotional empathy and prosocial behavior Social Cognitive and Affective Neuroscience October 4, 2013
- Can Drugs Be Used to Enhance the Psychotherapeutic Process? American Journal of Psychotherapy July 1, 1986
and 42 more in the library