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MDMA-assisted therapy is associated with a reduction in chronic pain among people with post-traumatic stress disorder

Devon Christie, Berra Yazar-Klosinski, Ekaterina Nosova, Pam Kryskow, Will Siu, Danielle Lessor, Elena Argento

Frontiers in Psychiatry November 3, 2022 DOI: 10.3389/fpsyt.2022.939302 (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Phase 2 open-label clinical trial Peer reviewed
Sample size 32
Population Adults with PTSD enrolled in an MDMA-assisted therapy trial
Intervention MDMA-assisted therapy
Topics MDMA PTSD
Citations 8
Registration NCT03282123
Key findings MDMA-assisted therapy significantly reduced chronic pain intensity and disability in participants with PTSD who had medium or high baseline pain severity.

Abstract

IntroductionIncreasing evidence demonstrates 3,4-methylenedioxymethamphetamine (MDMA)-assisted therapy (MDMA-AT) may be a safe and effective treatment for post-traumatic stress disorder (PTSD). There is growing interest in MDMA-AT to address a range of other health challenges. Chronic pain and PTSD are frequently comorbid, reciprocally interdependent conditions, though the possible role of MDMA-AT in treating chronic pain remains under-investigated. The present analysis examined the impact of manualized MDMA-AT on chronic pain severity among participants with PTSD who were enrolled in a Phase 2 clinical trial investigating MDMA-AT for PTSD (NCT03282123).Materials and methodsExploratory data from a subset of participants who completed chronic pain measures (n = 32) were drawn from a Phase 2 open-label study sponsored by the Multidisciplinary Association for Psychedelic Studies (MAPS). Multivariable analysis of variance (ANOVA) was utilized to compare pre- vs. post-treatment Chronic Pain Grade Scale (CPGS) values, adjusting for demographics (age, sex, and ethnicity). K-means clustering was then used to group the sample into three clusters to denote high (n = 9), medium (n = 11), and low (n = 12) baseline pain severity, and the same analysis was repeated for each cluster.ResultsAmong the 32 participants included in this analysis, 59% (n = 19) were women, 72% (n = 23) were white, and median age was 38 years [interquartile range (IQR) = 31–47]. Overall, 84% (n = 27) reported having pain, and 75% (n = 24) reported disability associated with their pain. Significant reductions in CPGS subscales for pain intensity and disability score, and overall CPGS severity grade were observed among participants in the highest pain cluster (n = 9, p < 0.05), and for pain intensity in the medium pain cluster (n = 11, p < 0.05) post- vs. pre-treatment.DiscussionFindings demonstrate a high prevalence of chronic pain in this sample of people with severe PTSD and that chronic pain scores among medium and high pain subgroups were significantly lower following MDMA-AT. While these data are preliminary, when considered alongside the frequency of comorbid chronic pain and PTSD and promising efficacy of MDMA-AT for treating PTSD, these findings encourage further research exploring the role of MDMA-AT for chronic pain.

Comparable studies

Other non-randomized and open-label trials on MDMA for PTSD, most cited first.

Study Year Design Participants
Durability of improvement in post-traumatic stress disorder symptoms and absence of harmful effects or drug dependency after 3,4-methylenedioxymethamphetamine-assisted psychotherapy: a prospective long-term follow-up study. Adults with chronic, treatment-resistant PTSD 2013 Long-term follow-up of a completed trial n = 19
MDMA-facilitated cognitive-behavioural conjoint therapy for posttraumatic stress disorder: an uncontrolled trial. Couples in which one partner was diagnosed with PTSD 2020 Pilot study n = 6
Culturally informed research design issues in a study for MDMA-assisted psychotherapy for posttraumatic stress disorder People of color with posttraumatic stress disorder 2019 Phase 2 open-label multisite study
3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy for victims of sexual abuse with severe post-traumatic stress disorder: an open label pilot study in Brazil. Patients with PTSD secondary to sexual abuse 2021 Open-label clinical trial n = 3
Relational and Growth Outcomes Following Couples Therapy With MDMA for PTSD. Romantic dyads where one partner had PTSD 2021 Pilot trial n = 6

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MDMA PTSD Psychedelic-assisted therapy

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