Efficacy of Psychoactive Drugs for the Treatment of Posttraumatic Stress Disorder: A Systematic Review of MDMA, Ketamine, LSD and Psilocybin
Tracey Varker, Loretta Watson, Kari Gibson, David Forbes, Meaghan O’donnell
Journal of Psychoactive Drugs September 15, 2020 DOI: 10.1080/02791072.2020.1817639 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review Peer reviewed |
|---|---|
| Sample size | 9 |
| Population | Adults with PTSD |
| Interventions | MDMA ketamine |
| Topics | Ketamine MDMA Psilocybin Esketamine LSD PTSD |
| Keywords | Hallucinogen Clinical psychology Psychoactive drug Checklist |
| Citations | 57 |
| Key findings | MDMA combined with psychotherapy has moderate-quality evidence for treating PTSD, while ketamine's evidence is very low to low. |
Abstract
The aim of this systematic review was to examine the efficacy of MDMA, ketamine, LSD, and psilocybin for the treatment of posttraumatic stress disorder (PTSD). A search of four databases for English language, peer-reviewed literature published from inception to 18th October 2019 yielded 2,959 records, 34 of which were screened on full-text. Observational studies and RCTs which tested the efficacy of MDMA, ketamine, LSD, or psilocybin for reducing PTSD symptoms in adults, and reported changes to PTSD diagnosis or symptomatology, were included. Nine trials (five ketamine and four MDMA) met inclusion criteria. Trials were rated on a quality and bias checklist and GRADE was used to rank the evidence. The evidence for ketamine as a stand-alone treatment for comorbid PTSD and depression was ranked "very low", and the evidence for ketamine in combination with psychotherapy as a PTSD treatment was ranked "low". The evidence for MDMA in combination with psychotherapy as a PTSD treatment was ranked "moderate".
In the evidence
This study is part of the evidence base for 2 syntheses in the library. Here is how each one recorded it.
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Rated evidence for ketamine as a stand-alone treatment for comorbid PTSD and depression as very low, and ketamine plus psychotherapy as low, while MDMA plus psychotherapy was rated moderate.
Synthesized
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Of nine included trials (five ketamine, four MDMA), no psilocybin or LSD trials met inclusion criteria; MDMA plus psychotherapy had moderate-quality evidence and ketamine low to very low.
Synthesized
Comparable studies
Other systematic reviews and meta-analyses on psilocybin for PTSD, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| A Systematic Review of the Neurocognitive Effects of Psychedelics in Healthy Populations: Implications for Depressive Disorders and Post-Traumatic Stress Disorder Healthy individuals and patients with PTSD or MDD | 2024 | Systematic review | n = 43 |
| Psychedelic-Assisted Psychotherapy for Post-Traumatic Stress Disorder, Anxiety Disorders, Mood Disorders, or Substance Use Disorders Patients with various mental health conditions | 2021 | Systematic review | |
| A Systematic Review of the efficacy, safety, and Tolerability of Psychedelics in the Treatment of post-traumatic Stress Disorder | 2025 | Systematic review |