Discontinuation of medications classified as reuptake inhibitors affects treatment response of MDMA-assisted psychotherapy.
Allison A. Feduccia, Lisa Jerome, Michael C Mithoefer, Julie Holland
Psychopharmacology (Berl) November 21, 2020 Retracted DOI: 10.1007/s00213-020-05710-w (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Pooled analysis of phase 2 trials Randomized Peer reviewed |
|---|---|
| Sample size | 50 |
| Population | Participants with PTSD in phase 2 trials of MDMA-assisted psychotherapy |
| Intervention | MDMA-assisted psychotherapy |
| Dose | 75–125 mg |
| Topics | Psychedelic-assisted therapy MDMA |
| Keywords | MDMA-Assisted Psychotherapy Antidepressant discontinuation Reuptake inhibitors Medication management Medication tapering Drug cessation Ssri discontinuation Treatment response Therapeutic outcomes Therapeutic efficacy Clinical effectiveness Patient response |
| Citations | 39 |
| Key findings | Recent exposure to antidepressant drugs that target reuptake transporters may reduce treatment response to MDMA-assisted psychotherapy. |
Abstract
Abstract Rationale MDMA-assisted psychotherapy is under investigation as a novel treatment for posttraumatic stress disorder (PTSD). The primary mechanism of action of MDMA involves the same reuptake transporters targeted by antidepressant medications commonly prescribed for PTSD.
Objectives: Data were pooled from four phase 2 trials of MDMA-assisted psychotherapy. To explore the effect of tapering antidepressant medications, participants who had been randomized to receive active doses of MDMA (75–125 mg) were divided into two groups (taper group (n = 16) or non-taper group (n = 34)).
Methods: Between-group comparisons were made for PTSD and depression symptom severity at the baseline and the primary endpoint, and for peak vital signs across two MDMA sessions.
Results: Demographics, baseline PTSD, and depression severity were similar between the taper and non-taper groups. At the primary endpoint, the non-taper group (mean = 45.7, SD = 27.17) had a significantly (p = 0.009) lower CAPS-IV total scores compared to the taper group (mean = 70.3, SD = 33.60). More participants in the non-taper group (63.6%) no longer met PTSD criteria at the primary endpoint than those in the taper group (25.0%). The non-taper group (mean = 12.7, SD = 10.17) had lower depression symptom severity scores (p = 0.010) compared to the taper group (mean = 22.6, SD = 16.69). There were significant differences between groups in peak systolic blood pressure (p = 0.043) and diastolic blood pressure (p = 0.032).
Conclusions: Recent exposure to antidepressant drugs that target reuptake transporters may reduce treatment response to MDMA-assisted psychotherapy.
Comparable studies
Other non-randomized and open-label trials on MDMA and psychedelic-assisted therapy, most cited first.