MDMA-facilitated cognitive-behavioural conjoint therapy for posttraumatic stress disorder: an uncontrolled trial

This open-label study (n=12, 6 couples) describes the safety, tolerability, and efficacy of MDMA (75-100mg) in combination with cognitive-behavioral conjoint therapy (CBCT) where one half of the couple was battling with PTSD.

Abstract

Cognitive-behavioural conjoint therapy (CBCT) for PTSD has been shown to improve PTSD, relationship adjustment, and the health and well-being of partners. MDMA (3,4-methylenedioxymethamphetamine) has been used to facilitate an individual therapy for PTSD. This study was an initial test of the safety, tolerability, and efficacy of MDMAfacilitated CBCT. Six couples with varying levels of baseline relationship satisfaction in which one partner was diagnosed with PTSD participated in a condensed version of the 15-session CBCT protocol delivered over 7 weeks. There were two sessions in which both members of the couple were administered MDMA. All couples completed the treatment protocol, and there were no serious adverse events in either partner. There were significant improvements in clinician-assessed, patient-rated, and partner-rated PTSD symptoms (pre- to post-treatment/follow-up effect sizes ranged from d = 1.85–3.59), as well as patient depression, sleep, emotion regulation, and trauma-related beliefs. In addition, there were significant improvements in patient and partner-rated relationship adjustment and happiness (d =.64–2.79). These results are contextualized in relation to prior results from individual MDMA-facilitated psychotherapy and CBCT for PTSD alone. MDMA holds promise as a facilitator of CBCT to achieve more robust and broad effects on individual and relational functioning in those with PTSD and their partners.

Authors: Candice M. Monson, Anne C. Wagner, Ann T. Mithoefer, Rachel E. Liebman, Allison A. Feduccia, Lisa Jerome, Berra Yazar-Klosinski, Amy Emerson, Rick Doblin & Michael C. Mithoefer

Notes

This paper is the first recent study on MDMA-assisted psychotherapy for couples. Although this type of therapy has been practiced before (1960s, and later underground), no double-blind placebo-controlled studies have been done. This study lays the groundwork for such studies.

“The effect sizes for improvements in PTSD and common co-occurring conditions in this pilot study were greater than those found with individually delivered MDMA-facilitated psychotherapy for PTSD. In addition, the effects on PTSD, other symptoms, and relationship outcomes in this study were on par with, or greater than, those previously achieved with CBCT alone.”

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