MDMA-assisted psychotherapy for treatment of post-traumatic stress disorder: a systematic review with meta-analysis

This systematic review (2021) entails a meta-analysis of the current literature on MDMA-assisted therapy for the treatment of PTSD. It was found that MDMA significantly reduced CAPS scores and is generally safe and well-tolerated although side effects such as headache and nausea are commonly reported.

Abstract

“This article discusses current literature on the use of 3,4-methylenedioxymethamphetamine (MDMA) assisted psychotherapy in the treatment of post-traumatic stress disorder (PTSD). MDMA, the intended active ingredient in illicit Ecstasy or Molly products, is a psychedelic that causes an elevated mood, feeling of bonding, and increased energy. In MDMA assisted psychotherapy, patients are subjected to 2 or 3 multi hour sessions of therapy with a team of psychiatrists. The dosing of MDMA is used to allow the therapist to probe the underlying trauma without causing emotional distress. The use of MDMA-assisted psychotherapy treatment reduced patient’s Clinician-Administered PTSD Scale (CAPS) scores from baseline more than control psychotherapy [-22.03 (95%CI -38.53 to -5.52)] but with high statistical heterogeneity. MDMA-assisted psychotherapy enhanced the achievement of clinically significant reductions in CAPS scores [RR 3.65 (95%CI 2.39 to 5.57)] and CAPS score reductions sufficient to no longer meet the definition of PTSD [RR 2.10 (95%CI 1.37 to 3.21)] with no detected statistical heterogeneity. While therapy was generally safe and well tolerated, bruxism, anxiety, jitteriness, headache, and nausea are commonly reported. While MDMA assisted psychotherapy has been shown to be an effective therapy for PTSD patients with a reasonable safety profile, use of unregulated MDMA or use in the absence of a strongly controlled psychotherapeutic environment has considerable risks.”

Authors: Kimberley W. Smith, Dakota J. Sicignano, Adrian V. Hernandez & Michael White

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