Psychedelic-Assisted Psychotherapy for the Treatment of PTSD: A Systematic Review and Meta-Analysis
Fizza Mitter, Anton Sheptooha, Janni Leung, Sarangan Ketheesan, Wọlé Akóṣílè
Psychoactives June 8, 2026 DOI: 10.3390/psychoactives5020016 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review and meta-analysis Randomized Peer reviewed |
|---|---|
| Sample size | 358 |
| Population | Adults with post-traumatic stress disorder (PTSD) in randomized controlled trials |
| Interventions | MDMA-assisted psychotherapy Ketamine Cannabidiol |
| Topics | CBD MDMA Psychedelic-assisted therapy PTSD |
| Keywords | Systematic review Randomized controlled trial Clinical trial Meta-analysis Medline Psychotherapist Clinical psychology Hypnosis Placebo |
| Key findings | MDMA-assisted psychotherapy showed a significant moderate-to-large reduction in PTSD symptom severity, while ketamine and cannabidiol did not show significant or clear benefit. |
Abstract
Post-traumatic stress disorder (PTSD) remains inadequately treated by existing pharmacological and psychological interventions, prompting growing interest in psychedelic-assisted psychotherapy. Although randomised controlled trials have evaluated several psychedelic agents for PTSD, to our knowledge, no prior PTSD-specific synthesis has quantitatively examined multiple agent classes within a single review framework. This systematic review and meta-analysis searched PsycINFO, CINAHL, Embase, MEDLINE, and clinical trial registries to identify RCTs of psychedelic-assisted psychotherapy for PTSD. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool, and random-effects meta-analyses were conducted for efficacy outcomes; safety and therapeutic protocols were synthesised narratively. Eleven RCTs involving 358 participants met inclusion criteria, evaluating MDMA, ketamine, and cannabidiol, of which eight contributed to meta-analyses. MDMA-assisted psychotherapy demonstrated a significant moderate-to-large reduction in PTSD symptom severity with negligible heterogeneity, and participants were significantly more likely to achieve clinical response and loss of PTSD diagnosis. The pooled effect for ketamine was small and non-significant, and a single cannabidiol trial showed no clear benefit. All agents were generally well tolerated. MDMA-assisted psychotherapy showed a promising efficacy signal for PTSD symptom reduction, although safety data were heterogenous and remain insufficient for strong comparative conclusions. Evidence for ketamine and cannabidiol remains too limited to support clinical implementation and it is noted that the current evidence base is dominated by MDMA trials. Further adequately powered trials with standardised outcomes and direct comparative studies across agents are needed.
In the evidence
This study is part of the evidence base for 2 syntheses in the library. Here is how each one recorded it.
-
MDMA-assisted psychotherapy showed a significant moderate-to-large reduction in PTSD symptom severity with negligible heterogeneity, while ketamine and cannabidiol did not show clear benefit.
Synthesized
-
State of the evidence: CBD No effect
A single CBD trial showed no clear benefit for PTSD symptom reduction.
Synthesized
Comparable studies
Other systematic reviews and meta-analyses on MDMA and psychedelic-assisted therapy, most cited first.