MDMA-assisted therapy for PTSD and substance use disorders: A scoping review of feasibility and future directions
Teun L. Meijer, Amras van Opdorp, Wiebren Markus
Psychedelics March 31, 2026 DOI: 10.1016/j.psyche.2026.100014 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Scoping review Peer reviewed |
|---|---|
| Intervention | MDMA-assisted therapy |
| Topics | Addiction MDMA PTSD |
| Key findings | Seven reviews suggest MDMA-assisted therapy is efficacious and safe for PTSD, while only two studies provide preliminary safety evidence for SUD and PTSD-SUD. The authors conclude MDMA-AT shows potential as a feasible treatment for co-occurring PTSD and SUD, but conclusive evidence on its efficacy and safety for this population is lacking. |
Abstract
Objective: Posttraumatic Stress Disorder (PTSD) and Substance Use Disorder (SUD) frequently co-occur (PTSD-SUD). This co-occurrence is associated with reduced treatment efficacy compared to PTSD-only, underscoring the necessity for optimized or additional treatment options. MDMA-Assisted Therapy (MDMA-AT) has been investigated for PTSD, but patients with co-occurring SUD are frequently excluded. This scoping review (i) summarizes evidence on MDMA-AT’s efficacy and safety for PTSD, SUD and PTSD-SUD and (ii) integrates these findings to evaluate its feasibility for PTSD-SUD whilst providing future research directions.
Method: A systematic literature search through PubMed/MEDLINE, Web of Science, and PsycINFO.
Results: Seven reviews suggest MDMA-AT is efficacious and safe for PTSD and two studies provide preliminary safety evidence for SUD and PTSD-SUD.
Conclusions: MDMA-AT demonstrates potential as a feasible treatment for PTSD-SUD, yet conclusive evidence regarding its efficacy and safety for this population is lacking. Future studies should primarily explore MDMA-AT’s safety for PTSD-SUD across diverse SUD types and severities, thereby establishing a clearer empirical foundation for its feasibility.
Comparable studies
Other narrative reviews on MDMA for addiction, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Neuropharmacology of New Psychoactive Substances (NPS): Focus on the Rewarding and Reinforcing Properties of Cannabimimetics and Amphetamine-Like Stimulants | 2016 | Review | |
| Methamphetamine and MDMA (Ecstasy) Neurotoxicity: 'of Mice and Men' | 2004 | Review | |
| Use and abuse of dissociative and psychedelic drugs in adolescence Adolescent humans and preclinical animal models | 2021 | Review | |
| Can MDMA Play a Role in the Treatment of Substance Abuse? | 2013 | Review | |
| Neuroimaging in Human MDMA (Ecstasy) Users | 2008 | Review |
Citations in the library
Cites 35
- The Therapeutic Potential of Psychedelic Drugs: Past, Present, and Future. Neuropsychopharmacology April 26, 2017
- Differences Between the Mechanism of Action of MDMA, MBDB, and the Classic Hallucinogens. Identification of a New Therapeutic Class: Entactogens Journal of Psychoactive Drugs October 1, 1986
- 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
- MDMA-assisted therapy for moderate to severe PTSD: a randomized, placebo-controlled phase 3 trial. Nature Medicine October 1, 2023
- 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
and 30 more in the library