Skip to content

MDMA and psychedelic-assisted therapy

Studies whose primary subject is both MDMA and Psychedelic-assisted therapy, with an evidence synthesis read across the most-cited and most recent of them.

State of the evidence

Synthesized

Synthesized from 23 studies in the library · AI-generated, grounded in the abstracts below

Found by searching the library for MDMA, ecstasy, molly, methylenedioxymethamphetamine, Psychedelic-assisted therapy, psychedelic therapy, then ranked by relevance.

Across randomized trials, MDMA-assisted psychotherapy consistently reduces PTSD symptoms more than low-dose or placebo comparators, with moderate-to-large effects and some evidence of durability over months to years; smaller pilot trials in autistic adults with social anxiety and in life-threatening-illness anxiety point the same way, though the latter missed statistical significance. Evidence for other conditions (complex PTSD, borderline personality disorder, major depression) is largely indirect or theoretical. The main caveats are small samples, difficulty maintaining blinding, expectancy effects, few active comparators, and regulatory concern that the evidence was insufficient for approval.

Evidence by study

Direction is which way each study's own result points, not our rating of the study.

What the directions mean
Supports:
the study found the intervention worked, or its hypothesis held.
Opposes:
it found the opposite, no benefit or a harm.
No effect:
no significant difference either way.
Mixed:
effects in both directions within the same study.
Unclear:
the abstract does not report a direction.
Study Design Sample size Direction Finding
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. 2010 RCT (pilot) Supports MDMA-assisted psychotherapy reduced PTSD symptoms more than placebo therapy.
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. 2018 RCT (phase 2, dose-response) Supports The active MDMA dose produced significant and lasting PTSD symptom reductions compared with a lower dose.
A randomized, controlled pilot study of MDMA (±3,4-Methylenedioxymethamphetamine)-assisted psychotherapy for treatment of resistant, chronic Post-Traumatic Stress Disorder (PTSD) 2012 RCT (pilot) 12 Mixed Full-dose MDMA-assisted psychotherapy produced significant self-reported PTSD improvement but clinician-rated CAPS reductions were not statistically significant; no drug-related serious adverse events occurred.
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. 2013 long-term follow-up 19 Supports Symptom gains were maintained over a mean of 45.4 months with no reported harm or drug dependency, though two participants relapsed.
Reduction in social anxiety after MDMA-assisted psychotherapy with autistic adults: a randomized, double-blind, placebo-controlled pilot study. 2018 RCT (pilot) 12 Supports MDMA-assisted psychotherapy produced significantly greater and durable reductions in social anxiety than placebo, with very large effect sizes.
Novel psychopharmacological therapies for psychiatric disorders: psilocybin and MDMA. 2016 review Supports Psilocybin and MDMA show promise as adjuncts to psychotherapy for several difficult-to-treat conditions, including refractory PTSD and social anxiety in autistic adults.
3,4-Methylenedioxymethamphetamine-assisted psychotherapy for treatment of chronic posttraumatic stress disorder: A randomized phase 2 controlled trial. 2018 RCT (phase 2, dose-response) 28 Supports Active MDMA doses (100 and 125 mg) produced larger PTSD symptom reductions than a 40 mg dose, with 76% no longer meeting PTSD criteria at 12-month follow-up.
MDMA-assisted psychotherapy for PTSD: Are memory reconsolidation and fear extinction underlying mechanisms? 2018 review Supports Proposes that MDMA-assisted psychotherapy for PTSD may work by enhancing memory reconsolidation and fear extinction via modulation of emotional memory circuits.
MDMA-Assisted Psychotherapy Using Low Doses in a Small Sample of Women with Chronic Posttraumatic Stress Disorder 2008 observational cohort 6 Supports Low doses of MDMA (50-75 mg) were psychologically and physiologically safe in all six women, with preliminary efficacy data; larger studies with higher doses are needed.
Breakthrough for Trauma Treatment: Safety and Efficacy of MDMA-Assisted Psychotherapy Compared to Paroxetine and Sertraline 2019 review Supports Pooled Phase 2 data indicate a large effect size for MDMA-assisted psychotherapy for PTSD, with lower dropout than sertraline or paroxetine trials.
MDMA-assisted psychotherapy for treatment of anxiety and other psychological distress related to life-threatening illnesses: a randomized pilot study 2020 RCT (pilot) 18 No effect MDMA-assisted psychotherapy produced a greater reduction in anxiety scores than placebo, but the group difference did not reach statistical significance.
Therapeutic effect of increased openness: Investigating mechanism of action in MDMA-assisted psychotherapy. 2017 RCT (secondary analysis) Supports Changes in openness, but not neuroticism, moderated the relationship between reduced PTSD symptoms and MDMA treatment, with increased openness and decreased neuroticism at long-term follow-up.
A Review of 3,4-methylenedioxymethamphetamine (MDMA)-Assisted Psychotherapy 2019 review Supports Reviews MDMA-assisted psychotherapy for PTSD as entering Phase 3 trials, with additional potential applications in autism-related anxiety and alcohol use disorder.
Oncology Providers' Perspectives on Psychedelic-Assisted Therapy. 2026 cross-sectional survey 385 Opposes Most oncology providers (80%) were uncomfortable counseling patients on psychedelic-assisted therapy and only 44% were familiar with its legal status; willingness to recommend it was linked to familiarity with emerging data and legal knowledge.
Changes in trauma symptoms of discrimination after MDMA-assisted psychotherapy for posttraumatic stress disorder. 2026 preliminary study 5 Supports MDMA-assisted therapy significantly reduced discrimination-related trauma symptoms, with a 38% decrease in TSDS scores and a large effect size.
Making a case for using MDMA-assisted psychotherapy for borderline personality disorder and complex PTSD: a descriptive systematic review of the literature 2026 systematic review 335 Mixed Most studies reported reduced PTSD symptoms after MDMA-assisted psychotherapy, but no studies directly assessed complex PTSD or borderline personality disorder, so applicability to those conditions remains hypothetical.
Psychedelic-Assisted Psychotherapy for the Treatment of PTSD: A Systematic Review and Meta-Analysis 2026 systematic review and meta-analysis 358 Supports MDMA-assisted psychotherapy showed a significant moderate-to-large reduction in PTSD symptom severity with negligible heterogeneity, while ketamine and cannabidiol did not show clear benefit.
From therapeutic promise to evidentiary discipline: Reassessing MDMA-assisted psychotherapy for posttraumatic stress disorder. 2026 commentary Unclear Argues that blinding difficulties, expectancy effects, absence of robust active comparators, limited mechanistic clarity, and safety-monitoring and generalizability concerns are central to interpreting MDMA-assisted psychotherapy, and that recovery indicators beyond symptom reduction are needed.
MDMA-Assisted Psychotherapy for Cluster B Personality Disorders: A Narrative Review of This Translational Framework for Relational Healing 2026 narrative review Unclear Proposes that MDMA-assisted psychotherapy may be a promising adjunct for Cluster B personality disorders by targeting attachment, trust, and emotion-regulation deficits, while noting empirical evidence remains limited.
Development of the MDMA-Assisted Psychotherapy Side Effects Tool (M-SET): a Delphi study. 2026 Delphi tool development 12 Supports Expert consensus produced a 165-item tool (M-SET) to systematically assess side effects of MDMA-assisted psychotherapy across screening, baseline, dosing, and follow-up.
State of the Science: MDMA‐assisted psychotherapy for the treatment of posttraumatic stress disorder 2026 review Mixed MDMA-assisted psychotherapy has shown promising response and remission rates in randomized trials, but the FDA declined approval in August 2024 citing insufficient evidence, and blinding, active comparators, safety monitoring, and generalizability remain limitations.
MDMA-assisted psychotherapy in major depression: critical considerations for clinical translation: commentary, Kvam et al. 2026 commentary Unclear Argues that MDMA-assisted psychotherapy for major depression requires further rigorous study to address methodological and ethical concerns before clinical translation.
Experiences of Australian clinicians, researchers, and patients with MDMA-assisted psychotherapy for post-traumatic stress disorder: A framework-guided qualitative analysis. 2026 qualitative study 21 Supports Participants described perceived therapeutic benefits and emphasized expectation management, comprehensive screening, consent, therapeutic alliance, integration of care, and provider training.

Points of agreement

  • Multiple randomized trials report that MDMA-assisted psychotherapy reduces PTSD symptoms more than low-dose or placebo comparators.
  • Symptom gains appear durable in several follow-ups, including 12-month and multi-year assessments.
  • MDMA is studied as an adjunct to psychotherapy rather than a stand-alone drug.
  • Trials generally report acceptable safety and tolerability, with no drug-related serious adverse events in the pilots.
  • Reviews and commentaries agree that blinding, expectancy, and lack of active comparators complicate interpretation.

Conflicts

  • Some trials report statistically significant clinician-rated PTSD improvement while others report significance only on self-report or only in per-protocol analyses.
  • One pilot in life-threatening-illness anxiety found a large but non-significant group difference, contrasting with significant PTSD findings.
  • Reviews describe promising efficacy while regulatory review concluded the evidence was insufficient for approval.
  • Commentaries emphasize unresolved methodological and safety concerns that efficacy-focused reviews treat as secondary.

Gaps

  • Small sample sizes across most trials, limiting precision and generalizability.
  • Difficulty maintaining blinding and controlling expectancy effects.
  • Few active comparator or head-to-head comparisons between therapy models.
  • Limited data on complex PTSD, borderline personality disorder, major depression, and other conditions beyond PTSD.
  • Inconsistent and heterogeneous safety monitoring, with a side-effect tool only recently developed.
  • Limited diversity and generalizability of samples, and little evidence on scalability, therapist training, and equity.
Browse these studies in the library

Common questions

What does the research agree on about MDMA and psychedelic-assisted therapy?
  • Multiple randomized trials report that MDMA-assisted psychotherapy reduces PTSD symptoms more than low-dose or placebo comparators.
  • Symptom gains appear durable in several follow-ups, including 12-month and multi-year assessments.
  • MDMA is studied as an adjunct to psychotherapy rather than a stand-alone drug.
  • Trials generally report acceptable safety and tolerability, with no drug-related serious adverse events in the pilots.
  • Reviews and commentaries agree that blinding, expectancy, and lack of active comparators complicate interpretation.
Where do studies on MDMA and psychedelic-assisted therapy conflict?
  • Some trials report statistically significant clinician-rated PTSD improvement while others report significance only on self-report or only in per-protocol analyses.
  • One pilot in life-threatening-illness anxiety found a large but non-significant group difference, contrasting with significant PTSD findings.
  • Reviews describe promising efficacy while regulatory review concluded the evidence was insufficient for approval.
  • Commentaries emphasize unresolved methodological and safety concerns that efficacy-focused reviews treat as secondary.
What is still unknown about MDMA and psychedelic-assisted therapy?
  • Small sample sizes across most trials, limiting precision and generalizability.
  • Difficulty maintaining blinding and controlling expectancy effects.
  • Few active comparator or head-to-head comparisons between therapy models.
  • Limited data on complex PTSD, borderline personality disorder, major depression, and other conditions beyond PTSD.
  • Inconsistent and heterogeneous safety monitoring, with a side-effect tool only recently developed.
  • Limited diversity and generalizability of samples, and little evidence on scalability, therapist training, and equity.
How we analyze this

This synthesis reads the 15 most-cited and 10 most recent studies whose primary subject is MDMA and psychedelic-assisted therapy, up to 25 in all. The most-cited set anchors the established evidence, and the recent set surfaces work that is too new to have gathered citations yet.

A study qualifies only when MDMA and psychedelic-assisted therapy or a known alias appears in its title or keywords, so broad reviews that mention it only in passing are left out. Each study is read from its abstract, strongest evidence first, and the summary reports the direction of the results along with any conflicts and gaps.

The full method, including what a person does and does not review, is on the methods page.

Ask your own question in the Research Synthesis Tool

150 articles · 53 from the last two years · 6,076 participants across 56 studies reporting sample size

Common study designs

review 41 qualitative study 10 systematic review 9 randomized controlled trial 8 theoretical or philosophical paper 17

Research volume by year

Compare topics →

146 studies whose primary subject is MDMA and psychedelic-assisted therapy since 2007

Studies about MDMA and psychedelic-assisted therapy per year, 2007 to 2026, peaking at 31 in 2024 Bar chart: one bar per year, taller where more studies were published that year. 0 20 40 2010 2015 2020 2025
2026 is partial
Show the numbers
Studies about MDMA and psychedelic-assisted therapy per year, 2007 to 2026, peaking at 31 in 2024
Year Studies
2007 1
2008 1
2009 0
2010 1
2011 0
2012 1
2013 1
2014 0
2015 1
2016 3
2017 2
2018 5
2019 7
2020 10
2021 14
2022 14
2023 15
2024 31
2025 25
2026 14

Research

Synthesize the evidence →

Oncology Providers' Perspectives on Psychedelic-Assisted Therapy.

The American journal of hospice & palliative care August 28, 2026 Krishna Hanubal, Akul Munjal, Jino Park et al.

PurposeDespite most psychedelic substances remaining Schedule I, clinical research exploring psychedelic-assisted therapy (PAT) in oncology is expanding. We sought to assess oncology providers' attitudes toward and understanding of PAT.MethodsWe conducted a cross-sectional survey of healthcare professionals involved in oncology across five academic institutions in California, South Carolina,...

DOI: 10.1177/10499091261483604 (opens in new tab) Full text (opens in new tab) MDMA Ketamine Psilocybin Antidepressants +4

Changes in trauma symptoms of discrimination after MDMA-assisted psychotherapy for posttraumatic stress disorder.

Scientific Reports July 11, 2026 Monnica T. Williams, Sonya C. Faber, Jordan Sloshower et al.

This preliminary study explored the effects of MDMA-assisted therapy on trauma symptoms related to discrimination, as measured by the Trauma Symptoms of Discrimination Scale (TSDS). A total of five diverse participants, who experienced multiple types of discrimination (e.g., gender, racial/ethnic, social class, age, sexual orientation), were assessed before and after treatment. A paired-samples...

DOI: 10.1038/s41598-026-59333-w (opens in new tab) Full text (opens in new tab) MDMA Discrimination Oppression Trauma

Making a case for using MDMA-assisted psychotherapy for borderline personality disorder and complex PTSD: a descriptive systematic review of the literature

Therapeutic Advances in Psychopharmacology July 1, 2026 Karthika Kasiviswanathan, Dinuli Nilaweera, M Morando et al.

Background: 3,4-Methylenedioxymethamphetamine (MDMA)-assisted psychotherapy (MDMA-AP) has demonstrated considerable efficacy in treating post-traumatic stress disorder (PTSD). PTSD and complex PTSD (CPTSD) frequently co-occur with borderline personality disorder (BPD), a complex disorder marked by emotional dysregulation, interpersonal difficulties and abandonment fears - often accompanied by...

DOI: 10.1177/20451253251408626 (opens in new tab) Ecstasy Borderline personality disorder Psycinfo Abandonment legal +10

Psychedelic-Assisted Psychotherapy for the Treatment of PTSD: A Systematic Review and Meta-Analysis

Psychoactives June 8, 2026 Fizza Mitter, Anton Sheptooha, Janni Leung et al.

Post-traumatic stress disorder (PTSD) remains inadequately treated by existing pharmacological and psychological interventions, prompting growing interest in psychedelic-assisted psychotherapy. Although randomised controlled trials have evaluated several psychedelic agents for PTSD, to our knowledge, no prior PTSD-specific synthesis has quantitatively examined multiple agent classes within a...

DOI: 10.3390/psychoactives5020016 (opens in new tab) MDMA Cannabidiol Systematic review Randomized controlled trial +7

MDMA-Assisted Psychotherapy for Cluster B Personality Disorders: A Narrative Review of This Translational Framework for Relational Healing

European Psychiatry June 1, 2026 M. Rocha, V. Sharma, S. Prasad et al.

Introduction Psychedelic-assisted psychotherapy has re-emerged as a frontier of psychiatry, offering transformative potential for conditions resistant to conventional treatment. Personality disorders—particularly Borderline Personality Disorder (BPD)—are marked by affective instability, interpersonal dysfunction, and maladaptive relational patterns that often limit therapeutic progress. MDMA’s...

DOI: 10.1192/j.eurpsy.2026.11914 (opens in new tab) Full text (opens in new tab) Borderline personality disorder Openness to experience Interpersonal communication Narrative review +13

From therapeutic promise to evidentiary discipline: Reassessing MDMA-assisted psychotherapy for posttraumatic stress disorder.

Journal of Traumatic Stress June 1, 2026 Kadek Suhardita, Veno Dwi Krisnanda, Rikas Saputra et al.

In this commentary on Morland et al. (2026)'s recent State of the Science article on 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy for posttraumatic stress disorder (PTSD), we aim to emphasize both MDMA's therapeutic promise and its unresolved scientific challenges. Although recent trials on MDMA-assisted interventions have reported encouraging reductions in PTSD symptoms, the...

DOI: 10.1002/jts.70094 (opens in new tab) Full text (opens in new tab)

Development of the MDMA-Assisted Psychotherapy Side Effects Tool (M-SET): a Delphi study.

BMJ Open May 11, 2026 Julia Colcott, Alexandre A. Guerin, Olivia Carter et al.

Despite growing interest in the therapeutic potential of 3,4-methylenedioxymethamphetamine (MDMA), no targeted measure to systematically assess side effects of MDMA-assisted psychotherapy (MDMA-AP) exists. Our aim was to develop an MDMA-Assisted Psychotherapy Side Effects Tool (M-SET) to capture side effects over the course of MDMA-AP. Informed by a systematic review and a review of other...

DOI: 10.1136/bmjopen-2025-105630 (opens in new tab) Full text (opens in new tab) Adult psychiatry Adverse events

State of the Science: MDMA‐assisted psychotherapy for the treatment of posttraumatic stress disorder

Journal of Traumatic Stress March 12, 2026 Leslie A. Morland, Barbara O Rothbaum, Lauren M. Sippel et al. 2 citations

There is growing interest in novel approaches to treating posttraumatic stress disorder (PTSD), including the use of psychedelic substances combined with psychotherapy, often referred to as psychedelic-assisted therapy, to better meet the needs of patients who do not prefer or respond to traditional evidence-based treatments. Among these treatments, 3,4-methylenedioxymethamphetamine...

DOI: 10.1002/jts.70060 (opens in new tab) Posttraumatic stress Cognition Cognitive behavioral therapy Leverage statistics +9

Experiences of Australian clinicians, researchers, and patients with MDMA-assisted psychotherapy for post-traumatic stress disorder: A framework-guided qualitative analysis.

Journal of Affective Disorders February 2, 2026 Alene Sze Jing Yong, Aimee Freeburn, Suzie Bratuskins et al.

Australia recently became the first country to reschedule methylenedioxymethamphetamine (MDMA) to permit authorized prescribing for post-traumatic stress disorder (PTSD) outside of clinical trials. This study explored the direct experience of Australian clinicians, researchers, and patients regarding the use of MDMA-assisted psychotherapy (MDMA-AP) for PTSD to inform guideline development....

DOI: 10.1016/j.jad.2026.121276 (opens in new tab) Full text (opens in new tab)

Placebo Effects in the Treatment of Depression-Implications for the Psychedelic Renaissance.

Neurologic Clinics February 1, 2026 Mina Ansari, Sophie I Elliott, Sophie E Holmes et al. 1 citation

The development of novel, rapid-acting treatments and the resurgence of interest in the therapeutic potential of psychedelic-like compounds has stimulated excitement and enthusiasm within the pharmaceutical industry, and provided new hope for millions of individuals suffering with mental illness such as major depressive disorder and post-traumatic stress disorder. This review summarizes the...

DOI: 10.1016/j.ncl.2025.08.009 (opens in new tab) Full text (opens in new tab) Ketamine MDMA Psilocybin Psychedelic therapy +6

Clinical trials

All mdma and psychedelic-assisted therapy trials →