MDMA‐Assisted Psychotherapy for Treatment of Posttraumatic Stress Disorder: A Systematic Review With Meta‐Analysis
K W Smith, Dakota Sicignano, Adrían V. Hernández, C Michael White
The Journal of Clinical Pharmacology October 28, 2021 DOI: 10.1002/jcph.1995 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Peer reviewed |
|---|---|
| Topics | MDMA Psychedelic-assisted therapy PTSD |
| Keywords | Psychotherapist Mood Clinical psychology |
| Citations | 136 |
| Key findings | MDMA-assisted psychotherapy reduces PTSD symptoms more than control therapy, with greater likelihood of clinically significant improvement and loss of PTSD diagnosis. |
Abstract
Abstract This article discusses current literature on the use of 3,4‐methylenedioxymethamphetamine (MDMA)‐assisted psychotherapy in the treatment of posttraumatic stress disorder (PTSD). MDMA, the intended active ingredient in illicit Ecstasy or Molly products, is a psychedelic that causes an elevated mood, feeling of bonding, and increased energy. In MDMA‐assisted psychotherapy, patients are subjected to 2 or 3 multihour sessions of therapy with a team of psychiatrists. The dosing of MDMA is used to allow the therapist to probe the underlying trauma without causing emotional distress. The use of MDMA‐assisted psychotherapy treatment reduced patient's Clinician‐Administered PTSD Scale (CAPS) scores from baseline more than control psychotherapy (–22.03; 95%CI, –38.53 to –5.52) but with high statistical heterogeneity. MDMA‐assisted psychotherapy enhanced the achievement of clinically significant reductions in CAPS scores (relative risk, 3.65; 95%CI, 2.39‐5.57) and CAPS score reductions sufficient to no longer meet the definition of PTSD (relative risk, 2.10; 95%CI, 1.37‐3.21) with no detected statistical heterogeneity. While therapy was generally safe and well tolerated, bruxism, anxiety, jitteriness, headache, and nausea are commonly reported. While MDMA‐assisted psychotherapy has been shown to be an effective therapy for patients with PTSD with a reasonable safety profile, use of unregulated MDMA or use in the absence of a strongly controlled psychotherapeutic environment has considerable risks.
In the evidence
This study is part of the evidence base for a synthesis in the library. Here is how each one recorded it.
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State of the evidence: MDMA for PTSD Supports
MDMA-assisted psychotherapy reduced CAPS scores more than control psychotherapy (mean difference -22.03) with high heterogeneity, and increased rates of clinically significant improvement (RR 3.65) and loss of PTSD diagnosis (RR 2.10).
Synthesized
Comparable studies
Other narrative reviews on MDMA and psychedelic-assisted therapy, most cited first.