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A randomized, controlled pilot study of MDMA (±3,4-Methylenedioxymethamphetamine)-assisted psychotherapy for treatment of resistant, chronic Post-Traumatic Stress Disorder (PTSD)

Peter Oehen, Rafael Traber, Verena Widmer, Ulrich Schnyder

Journal of Psychopharmacology October 31, 2012 DOI: 10.1177/0269881112464827 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Randomized controlled trial Placebo-controlled Double-blind Pilot study Peer reviewed
Sample size 12
Population Patients with treatment-resistant PTSD
Intervention MDMA-assisted psychotherapy
Dose low-dose (25 mg, plus 12.5 mg supplemental dose) or full-dose MDMA (125 mg, plus 62.5 mg supplemental dose)
Duration Three experimental sessions interspersed with weekly non-drug-based psychotherapy sessions; assessments at baseline, three weeks after the second and third MDMA session, and at 2-month and 1-year follow-ups
Topics MDMA Psychedelic-assisted therapy PTSD
Keywords Randomized controlled trial Placebo Adverse effect
Citations 407
Key findings MDMA-assisted psychotherapy can be safely administered and produced clinically and statistically significant self-reported improvement in PTSD symptoms, though clinician-rated reductions were not statistically significant.

Abstract

Psychiatrists and psychotherapists in the US (1970s to 1985) and Switzerland (1988–1993) used MDMA legally as a prescription drug, to enhance the effectiveness of psychotherapy. Early reports suggest that it is useful in treating trauma-related disorders. Recently, the first completed pilot study of MDMA-assisted psychotherapy for PTSD yielded encouraging results. Designed to test the safety and efficacy of MDMA-assisted psychotherapy in patients with treatment-resistant PTSD; our randomized, double-blind, active-placebo controlled trial enrolled 12 patients for treatment with either low-dose (25 mg, plus 12.5 mg supplemental dose) or full-dose MDMA (125 mg, plus 62.5 mg supplemental dose). MDMA was administered during three experimental sessions, interspersed with weekly non-drug-based psychotherapy sessions. Outcome measures used were the Clinician-Administered PTSD Scale (CAPS) and the Posttraumatic Diagnostic Scale (PDS). Patients were assessed at baseline, three weeks after the second and third MDMA session (end of treatment), and at the 2-month and 1-year follow-ups. We found that MDMA-assisted psychotherapy can be safely administered in a clinical setting. No drug-related serious adverse events occurred. We did not see statistically significant reductions in CAPS scores ( p = 0.066), although there was clinically and statistically significant self-reported (PDS) improvement ( p = 0.014). CAPS scores improved further at the 1-year follow-up. In addition, three MDMA sessions were more effective than two ( p = 0.016).

In the evidence

This study is part of the evidence base for 4 syntheses in the library. Here is how each one recorded it.

  • Full-dose MDMA-assisted psychotherapy produced significant self-reported PTSD improvement but clinician-rated CAPS reductions were not statistically significant; no drug-related serious adverse events occurred.

    Synthesized

  • MDMA-assisted psychotherapy was safely administered and produced statistically significant self-reported improvement (PDS, p = 0.014), but clinician-rated CAPS reductions were not statistically significant (p = 0.066); CAPS scores improved further at 1-year follow-up.

    Synthesized

  • MDMA-assisted psychotherapy was safe and produced clinically and statistically significant self-reported improvement in PTSD symptoms, but clinician-rated reductions were not statistically significant.

    Synthesized

  • MDMA-assisted psychotherapy produced statistically significant self-reported PTSD improvement but clinician-rated reductions were not statistically significant.

    Synthesized

Comparable studies

Other randomized controlled trials on MDMA and psychedelic-assisted therapy, most cited first.

Study Year Design Participants
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. Patients with chronic post-traumatic stress disorder refractory to both psychotherapy... 2010 Randomized controlled trial n = 20
3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy for post-traumatic stress disorder in military veterans, firefighters, and police officers: a randomised, double-blind, dose-response, phase 2 clinical trial. Military veterans and first responders aged 18 or older with chronic PTSD lasting 6... 2018 Randomized, double-blind, dose-response, phase 2 clinical trial n = 26
Reduction in social anxiety after MDMA-assisted psychotherapy with autistic adults: a randomized, double-blind, placebo-controlled pilot study. Autistic adults with marked to very severe social anxiety 2018 Randomized controlled trial n = 12
3,4-Methylenedioxymethamphetamine-assisted psychotherapy for treatment of chronic posttraumatic stress disorder: A randomized phase 2 controlled trial. People with chronic posttraumatic stress disorder 2018 Randomized controlled trial n = 28
MDMA-assisted psychotherapy for treatment of anxiety and other psychological distress related to life-threatening illnesses: a randomized pilot study People with life-threatening illnesses and anxiety 2020 Randomized controlled trial n = 18

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