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
Australian & 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.
Comparable studies
Other narrative reviews on MDMA and psychedelic-assisted therapy, most cited first.
Citations in the library
Cited by 15
- Side-effects of mdma-assisted psychotherapy: a systematic review and meta-analysis Neuropsychopharmacology April 23, 2024
- MDMA-assisted psychotherapy for PTSD in adolescents: rationale, potential, risks, and considerations. European Child & Adolescent Psychiatry November 1, 2024
- Autism, youth suicide, and psychedelics: A review of the 21st century evidence. Journal of the Chinese Medical Association : JCMA October 1, 2024
- A Review of MDMA-Assisted Therapy for Posttraumatic Stress Disorder. Focus July 1, 2023
- Expert opinions on implementation of MDMA-assisted therapy in Europe: critical appraisal towards training, clinical practice, and regulation. European Journal of Psychotraumatology 2024
and 10 more in the library
Cites 30
- Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: a randomized controlled trial Journal of Psychopharmacology November 30, 2016
- MDMA-assisted therapy for severe PTSD: a randomized, double-blind, placebo-controlled phase 3 study. Nature Medicine June 1, 2021
- 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. Journal of Psychopharmacology July 19, 2010
- 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. The Lancet Psychiatry May 1, 2018
- Ketamine for rapid reduction of suicidal thoughts in major depression: a midazolam-controlled randomized clinical trial American Journal of Psychiatry December 5, 2017
and 25 more in the library