Prevalence of Potential Contraindications and Risk Factors Relevant to MDMA-Assisted Therapy Among U.S. Veterans with Posttraumatic Stress Disorder
Catherine S. Hwang, David C. Cameron, Allison O’Neill, Benjamin J. Morasco, Steven K. Dobscha, Philip Todd Korthuis, Christopher S. Stauffer
Journal of Psychoactive Drugs August 5, 2026 DOI: 10.1080/02791072.2026.2710059 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Serial cross-sectional study Peer reviewed |
|---|---|
| Population | U.S. Veterans with PTSD receiving care, 303,451 to 326,315 participants per year |
| Topics | MDMA PTSD |
| Key findings | Each year, 15.3% to 17.3% of veterans with PTSD had at least one contraindication for MDMA-assisted therapy, 55.2% to 58.2% had at least one conditional or modifiable risk factor, and 85.7% to 87.5% filled a prescription for a potentially interacting medication. Many may be eligible with careful management. |
Abstract
3,4-methylenedioxymethamphetamine (MDMA)-assisted therapy has emerged as a potential strategy to treat posttraumatic stress disorder (PTSD). We conducted a national serial cross-sectional study of U.S. Veterans with PTSD from January 1, 2018, to December 31, 2023, to quantify the prevalence of potential contraindications, risk factors, and drug-drug interactions relevant to MDMA-assisted therapy. Participants were required to have at least two diagnostic codes for PTSD within a calendar year. Each year, 303,451 to 326,315 participants received care for PTSD. The annual proportion of individuals with at least one contraindication for MDMA-assisted therapy ranged from 15.3% to 17.3%, and the annual proportion with at least one conditional or modifiable risk factor ranged from 55.2% to 58.2%. Each year, 85.7% to 87.5% of participants filled at least one prescription for another medication that potentially interacts with MDMA. Many individuals with PTSD have contraindications or conditional risk factors that may require additional evaluation prior to receiving MDMA-assisted therapy, but many may be eligible with careful management of modifiable conditions and potential drug-drug interactions. Our results have important implications for policymakers and clinicians as studies examining the safety and efficacy of MDMA-assisted therapy continue to evolve toward potential implementation.
In the evidence
This study is part of the evidence base for a synthesis in the library. Here is how each one recorded it.
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Each year 15.3-17.3% of veterans with PTSD had at least one contraindication for MDMA-assisted therapy, 55.2-58.2% had a conditional or modifiable risk factor, and 85.7-87.5% filled a prescription for a potentially interacting medication.
Synthesized
Comparable studies
Other cross-sectional and survey studies on MDMA for PTSD, most cited first.
Citations in the library
Cites 21
- MDMA-assisted therapy for severe PTSD: a randomized, double-blind, placebo-controlled phase 3 study. Nature Medicine June 1, 2021
- MDMA-assisted therapy for moderate to severe PTSD: a randomized, placebo-controlled phase 3 trial. Nature Medicine October 1, 2023
- Cardiovascular and neuroendocrine effects and pharmacokinetics of 3, 4-methylenedioxymethamphetamine in humans. Journal of Pharmacology and Experimental Therapeutics July 1, 1999
- Cardiovascular Effects of 3,4-Methylenedioxymethamphetamine: A Double-Blind, Placebo-Controlled Trial Annals of Internal Medicine December 19, 2000
- First study of safety and tolerability of 3,4-methylenedioxymethamphetamine-assisted psychotherapy in patients with alcohol use disorder. Journal of Psychopharmacology February 18, 2021
and 16 more in the library