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Consistency of protocol and safety data reporting in clinical trial registrations and corresponding publications of interventions involving MDMA and psilocybin.

Marija Franka Žuljević, Antonija Mijatović, Renata Orhanović, Glenn Goasdoué, Diana Gujinović

Journal of Clinical Epidemiology January 23, 2026 DOI: 10.1016/j.jclinepi.2026.112170 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Cross-sectional analysis Qualitative Peer reviewed
Sample size 336
Population Clinical trials on MDMA or psilocybin registered on ClinicalTrials.gov
Topics MDMA Psilocybin
Keywords Clinicaltrials.gov Adverse events Pre-registration Psychedelics Reporting
Citations 4
Key findings Inconsistencies in protocol registration and adverse event reporting are widespread in MDMA and psilocybin clinical trials, with most completed trials failing to report results on time and few showing full concordance in adverse event reporting between registry and publications.

Abstract

MDMA and psilocybin are being investigated as potential treatments for psychiatric disorders and have received increasing regulatory and media attention, due to the methodological complexities and societal context of psychedelic substances. Therefore, we assessed the consistency of protocol registration and adverse event (AE) reporting in clinical trials of MDMA and psilocybin. We conducted a cross-sectional analysis of all clinical trials on MDMA or psilocybin registered on ClinicalTrials.gov by March 12, 2025. For each trial, we assessed changes to primary outcome measures (POMs) and eligibility criteria over time, and evaluated whether these changes were disclosed in corresponding publications. For completed trials with both posted results and published articles, we compared AE reporting between the article and the corresponding ClinicalTrials.gov registration. Out of 336 trials, major changes were recorded to POMs for 17.6% trials and to eligibility criteria for 28.6% trials, most of which occurred after participant recruitment began. Among completed trials, 72.0% did not report results on ClinicalTrials.gov, and most posted results exceeded the FDAAA-recommended one-year reporting window. Only 3 of 29 trials with both posted results and publications showed full concordance in AE reporting, with most exhibiting both qualitative and quantitative discrepancies. Inconsistencies in protocol and adverse event reporting undermine the credibility and safety evaluation of MDMA and psilocybin trials. Greater transparency and stricter adherence to reporting standards are advised to ensure reliable evidence, protect participants, and maintain stakeholder and public trust.

Comparable studies

Other cross-sectional and survey studies on MDMA, most cited first.

Study Year Design Participants
Recreational MDMA use in Sydney: a profile of ‘Ecstasy’ users and their experiences with the drug Recreational Ecstasy users recruited via snowball peer network 1992 Cross-sectional survey n = 100
Reducedin vivobinding to the serotonin transporter in the cerebral cortex of MDMA (‘ecstasy’) users Male regular ecstasy users and well-matched controls 1999 Cross-sectional association study n = 20
Patterns of simultaneous polysubstance use in drug using university students Drug-using university students 2006 Cross-sectional survey n = 149
Patterns of recreational drug use at dance events in Edinburgh, Scotland Drug users at dance events in Edinburgh, Scotland, UK, aged 16-47, 80% between 18 and... 2001 Cross-sectional survey n = 122
Acute, sub‐acute and long‐term subjective consequences of ‘ecstasy’ (MDMA) consumption in 430 regular users Regular MDMA users 2003 Cross-sectional study n = 466

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