MDMA-Based Psychotherapy in Treatment-Resistant Post-Traumatic Stress Disorder (PTSD): A Brief Narrative Overview of Current Evidence
Kainat Riaz, Sejal Suneel, Mohammad Hamza Bin Abdul Malik, Tooba Kashif, Irfan Ullah, Abdul Waris, Marco Di Nicola, Marianna Mazza, Gabriele Sani, Giovanni Martinotti, Domenico de Berardis
Diseases November 3, 2023 DOI: 10.3390/diseases11040159 (opens in new tab)
Study at a glance
AI-extracted from the abstractAbstract
Post-traumatic stress disorder (PTSD) is a debilitating mental health disorder that causes significant dysfunction in individuals. Currently, there are many approved pharmacotherapy and psychotherapy treatment options for PTSD, but unfortunately, half of the patients do not respond to traditional therapies. In this article, we review clinical trials and research on 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy in PTSD patients, its pharmacokinetics, and current treatment guidelines for PTSD. Our findings are based on the results of the efficacy of MDMA-assisted psychotherapy from six phase II randomized controlled trials. MDMA-assisted psychotherapy for PTSD has received the “breakthrough therapy” designation from the FDA. MDMA can reduce PTSD symptoms even in treatment-resistant cases by increasing certain neurohormones, i.e., dopamine, serotonin, norepinephrine, and oxytocin. It also modulates activities in the brain regions involved in fear and anxiety. Future research is needed to show whether the advantages outweigh the disadvantages and whether its use can be integrated into available treatment options for PTSD.
Comparable studies
Other narrative reviews on MDMA for PTSD, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Novel psychopharmacological therapies for psychiatric disorders: psilocybin and MDMA. | 2016 | Review | |
| MDMA-assisted psychotherapy for PTSD: Are memory reconsolidation and fear extinction underlying mechanisms? | 2018 | Review | |
| Clinical applications of hallucinogens: A review. | 2016 | Review | |
| MDMA‐Assisted Psychotherapy for Treatment of Posttraumatic Stress Disorder: A Systematic Review With Meta‐Analysis | 2021 | Review | |
| Registered clinical studies investigating psychedelic drugs for psychiatric disorders. Registered clinical trials on clinicaltrials.gov evaluating psychedelics for... | 2021 | Review | n = 70 |
Citations in the library
Cited by 11
- Neurochemical, Neurocircuitry, and Psychopathological Mechanisms of PTSD: Emerging Pharmacotherapies and Clinical Perspectives. ACS Chemical Neuroscience June 10, 2025
- The efficacy and safety of MDMA-assisted psychotherapy for treatment of posttraumatic stress disorder: A systematic review and meta-analysis from randomized controlled trials. Psychiatry Research September 1, 2024
- Novel psychedelic interventions for post-traumatic stress disorder and their promise for precision medicine. Therapeutic Advances in Psychopharmacology December 4, 2025
- Biological treatments for co-occurring eating disorders and psychological trauma: a systematic review. Frontiers in Psychiatry 2025
- Serotonergic psychedelics for Autism spectrum disorder: Neurobiological mechanisms and translational prospects. Progress in Neuro-Psychopharmacology and Biological Psychiatry June 20, 2026
and 6 more in the library
Cites 39
- MDMA-assisted therapy for severe PTSD: a randomized, double-blind, placebo-controlled phase 3 study. Nature Medicine June 1, 2021
- Human Pharmacology of MDMA Therapeutic Drug Monitoring March 19, 2004
- MDMA-assisted psychotherapy for treatment of PTSD: study design and rationale for phase 3 trials based on pooled analysis of six phase 2 randomized controlled trials. Psychopharmacology September 1, 2019
- Oxytocin-dependent reopening of a social reward learning critical period with MDMA Nature April 3, 2019
- 3,4‐Methylenedioxymethamphetamine (MDMA, “Ecstasy”): pharmacology and toxicology in animals and humans Addiction May 1, 1994
and 34 more in the library