MDMA-assisted psychotherapy for post-traumatic stress disorder: The devil is in the detail.
Gillinder Bedi, Susan M Cotton, Alexandre A. Guerin, Henry J Jackson
The Australian and New Zealand journal of psychiatry April 1, 2023 DOI: 10.1177/00048674221127186 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Peer reviewed |
|---|---|
| Intervention | MDMA-assisted psychotherapy |
| Topics | PTSD MDMA Psychedelic-assisted therapy |
| Keywords | MDMA-Assisted Psychotherapy Clinical trials Methodology Psychedelic medicine |
| Citations | 17 |
| Key findings | The authors argue that despite promising findings, the evidence base for MDMA-assisted psychotherapy for PTSD has methodological and design limitations, compounded by advocacy-group involvement and non-government financing, and that rigorous, independent trials are needed. |
Abstract
Recent years have seen escalating media, public and scientific interest in psychedelic medicine. Australia and New Zealand have been late to this research; however, in the past 2 years, rapid developments suggest that this is changing. Here, we argue for the need to critically review existing evidence in this field to guide future directions. We focus on (±)3,4-methylenedioxymethamphetamine-assisted psychotherapy for post-traumatic stress disorder, currently the most advanced area of clinical psychedelic research. Food and Drug Administration approval of this approach is likely in 2023, based on a series of promising findings. We provide a detailed overview of Phase 2 and 3 studies published to date. We identify several concerns related to this body of evidence, including methodological/design limitations and broader factors - such as robust involvement of advocacy groups in research and reliance on non-government financing leading to simplistic public messaging - that compound the methodological issues identified. We propose steps for future improvement, including the need for large, high-quality, independent efficacy trials with design enhancements, effectiveness trials and for researchers to consider their own engagement with media and public messaging around these modalities. We argue that, notwithstanding promising findings to date, rigorous and dispassionate science is needed to move the field forward and safeguard the welfare of participants.