This article (2023) advocates for MDMA-assisted psychotherapy (MDMA-AT) in treating adolescent PTSD, highlighting potential benefits such as reduced avoidance and enhanced therapeutic alliance. It proposes adaptations including stronger motivation reinforcement, additional emotion management techniques, and family involvement, and calls for clinical trials to assess safety and effectiveness.

Abstract of MDMA-AT for PTSD in Adolescents

“3,4-methylenedioxymetamphetamine(MDMA)-assisted psychotherapy (MDMA-AP) is a proposed treatment for posttraumatic stress disorder (PTSD) that may be approved for adults soon. PTSD is also common among trauma-exposed adolescents, and current treatments leave much room for improvement.

We present a rationale for considering MDMA-AP for treating PTSD among adolescents. Evidence suggests that as an adjunct to therapy, MDMA may reduce avoidance and enable trauma processing, strengthen therapeutic alliance, enhance extinction learning and trauma-related reappraisal, and hold potential beyond PTSD symptoms.

Drawing on existing trauma-focused treatments, we suggest possible adaptations to MDMA-AP for use with adolescents, focusing on 1) reinforcing motivation, 2) the development of a strong therapeutic alliance, 3) additional emotion and behavior management techniques, 4) more directive exposure-based methods during MDMA sessions, 5) more support for concomitant challenges and integrating treatment benefits, and 6) involving family in treatment. We then discuss potential risks particular to adolescents, including physical and psychological side effects, toxicity, misuse potential, and ethical issues.

We argue that MDMA-AP holds potential for adolescents suffering from PTSD. Instead of off-label use or extrapolating from adult studies, clinical trials should be carried out to determine whether MDMA-AP is safe and effective for PTSD among adolescents.”

Authors: Samuli Kangaslampi & Josjan Zijlmans

Summary of MDMA-AT for PTSD in Adolescents

Phase III clinical trials of MDMA-assisted psychotherapy (MDMA-AT/AP) for treating post-traumatic stress disorder (PTSD) among adults have finished, and U.S. Food and Drug Administration (FDA) approval looks likely in the coming year. Adolescents also suffer from high rates of PTSD, and new forms of treatment are called for.

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