3,4-methylenedioxymethamphetamine (MDMA), commonly known as ecstasy, is one of the most widely used illicit substances worldwide. MDMA-assisted psychotherapy has become a novel treatment for posttraumatic stress disorder (PTSD), and many randomized controlled trials (RCTs) have been performed over the past decade. Therefore, this study aimed to systematically review and demonstrate the efficacy and safety of MDMA-assisted psychotherapy for the treatment of PTSD. We conducted a systematic search of PubMed, Embase, and Web of Science databases up to October 27, 2023, selected RCTs assessing the efficacy and safety of MDMA-assisted psychotherapy for the treatment of PTSD, and evaluated their quality using the Cochrane risk of bias tool. Seven RCTs were selected from the retrieved references. The results revealed that MDMA-assisted psychotherapy effectively reduced the change from baseline score in the Clinician-Administered PTSD Scale in patients with PTSD compared with either placebo or active controls. However, MDMA causes a series of adverse events, including muscle tightness, nausea, and decreased appetite. To a certain extent, MDMA-assisted psychotherapy may improve symptoms in patients with PTSD. However, side effects and abuse issues still seriously hinder clinical application of MDMA.
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MDMA and MDMA-Assisted Therapy.
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January 2025
Directorate of Behavioral Health, Walter Reed National Military Medical Center, Bethesda, MD (Wolfgang); Departments of Psychiatry (Wolfgang) and Medical and Clinical Psychology (Gray), Uniformed Services University, Bethesda, MD; Departments of Psychiatry (Wolfgang, Krystal), Neuroscience (Krystal), and Psychology (Krystal), Yale University School of Medicine, New Haven, CT; Center for Psychedelic Research and Therapy, Department of Psychiatry and Behavioral Sciences, The University of Texas at Austin Dell Medical School (Fonzo, Nemeroff); Department of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, UCLA (Grzenda); Department of Psychiatry & Behavioral Sciences, University of Minnesota, Minneapolis (Widge); Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham (Kraguljac); Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (McDonald); Department of Psychiatry and Behavioral Sciences, Stanford University and Veterans Affairs Palo Alto Health Care System, Palo Alto, CA (Rodriguez).
Article Synopsis
- MDMA, also known as Ecstasy or Molly, has been used since the 1970s for both recreational and therapeutic purposes, with the FDA recognizing its potential for treating PTSD as a Breakthrough Therapy in 2017.
- The effects of MDMA in therapeutic settings are distinct, promoting trust and self-compassion while allowing cognitive clarity, which differentiates it from other psychedelics.
- Preliminary evidence indicates that MDMA-Assisted Therapy is effective, with 67%-71% of PTSD patients no longer meeting diagnostic criteria after treatment, significantly more than those receiving placebo therapy.
A reflection on paradigmatic tensions within the FDA advisory committee for MDMA-assisted therapy.
J Psychopharmacol
December 2024
Department of Psychology, University of Exeter, Exeter, UK.
The recent rejection of 3,4-methylenedioxymethamphetamine (MDMA)-assisted therapy by the U.S. Food and Drug Administration (FDA) is a dramatic moment in the re-emergence of psychedelic research.
View Article and Find Full Text PDFTherapeutic Potential of MDMA- and Psychedelic-Assisted Psychotherapy for Adolescent Depression and Trauma.
Curr Psychiatry Rep
December 2024
New York University Grossman School of Medicine, New York, USA.
Purpose Of Review: There is a mental health crisis affecting youth, and the utility of existing treatments is often limited by lack of effectiveness and tolerability. The aim of this review is to report on outcomes of clinical trials for psilocybin-assisted psychotherapy for adults with depression and MDMA-assisted psychotherapy for adults with post-traumatic stress disorder (PTSD) and discuss recommendations for exploring these treatments in adolescent populations.
Recent Findings: There have been encouraging data supporting the use of psilocybin-assisted psychotherapy for depression, including previously treatment-resistant symptoms.
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