Trial PaperPTSDSafety & Risk ManagementInterpersonal Functioning & Social ConnectednessMDMA

A randomized, controlled pilot study of MDMA (±3,4-Methylenedioxymethamphetamine)- assisted psychotherapy for treatment of resistant, chronic Post-Traumatic Stress Disorder (PTSD)

In a randomized, double‑blind, active‑placebo controlled pilot trial of 12 patients with treatment‑resistant chronic PTSD, MDMA‑assisted psychotherapy was safely administered with no drug‑related serious adverse events. The intervention produced significant self‑reported symptom improvement (PDS, p=0.014), a non‑significant clinician‑rated CAPS reduction at end‑of‑treatment (p=0.066) that improved by 1‑year follow‑up, and three MDMA sessions were more effective than two (p=0.016).

Authors

  • Oehen, P.
  • Traber, R.
  • Widmer, V.

Published

Journal of Psychopharmacology
individual Study

Abstract

Psychiatrists and psychotherapists in the US (1970s to 1985) and Switzerland (1988–1993) used MDMA legally as a prescription drug, to enhance the effectiveness of psychotherapy. Early reports suggest that it is useful in treating trauma-related disorders. Recently, the first completed pilot study of MDMA-assisted psychotherapy for PTSD yielded encouraging results. Designed to test the safety and efficacy of MDMA-assisted psychotherapy in patients with treatment-resistant PTSD; our randomized, double-blind, active-placebo controlled trial enrolled 12 patients for treatment with either low-dose (25 mg, plus 12.5 mg supplemental dose) or full-dose MDMA (125 mg, plus 62.5 mg supplemental dose). MDMA was administered during three experimental sessions, interspersed with weekly non-drug-based psychotherapy sessions. Outcome measures used were the Clinician-Administered PTSD Scale (CAPS) and the Posttraumatic Diagnostic Scale (PDS). Patients were assessed at baseline, three weeks after the second and third MDMA session (end of treatment), and at the 2-month and 1-year follow-ups. We found that MDMA-assisted psychotherapy can be safely administered in a clinical setting. No drug-related serious adverse events occurred. We did not see statistically significant reductions in CAPS scores ( p = 0.066), although there was clinically and statistically significant self-reported (PDS) improvement ( p = 0.014). CAPS scores improved further at the 1-year follow-up. In addition, three MDMA sessions were more effective than two ( p = 0.016).

Available with Blossom Pro

Research Summary of 'A randomized, controlled pilot study of MDMA (±3,4-Methylenedioxymethamphetamine)- assisted psychotherapy for treatment of resistant, chronic Post-Traumatic Stress Disorder (PTSD)'

Introduction

Post-traumatic stress disorder (PTSD) is common and often chronic, with substantial residual morbidity despite existing psychotherapies and serotonergic medications. Earlier research shows that exposure-based psychotherapies (for example CBT, Prolonged Exposure, CPT, EMDR) have efficacy but also high drop-out rates and incomplete recovery for many patients; SSRIs approved for PTSD produce only modest symptom change. Consequently, there is a recognised need for more effective pharmacological and psychotherapeutic approaches for treatment‑resistant, chronic PTSD. This study set out to evaluate MDMA-assisted psychotherapy as a novel, catalyst-style treatment for chronic, treatment‑resistant PTSD. MDMA is hypothesised to reduce fear and enhance prosocial and integrative emotional processing via serotonergic release, modulation of amygdala and ventromedial prefrontal cortex activity, and increased oxytocin, thereby widening an "optimal arousal" window for therapeutic exposure. Oehen and colleagues designed a randomised, double-blind, active-placebo controlled pilot trial to test safety and preliminary efficacy in 12 outpatients, to assess whether low-dose MDMA (25 mg + 12.5 mg) could serve as an active placebo to improve blinding, and to test the hypothesis that three MDMA sessions are more effective than two and that symptom reductions would persist at 1 year.

Expert Research Summaries

Go Pro to access AI-powered section-by-section summaries, editorial takes, and the full research toolkit.

Full Text PDF

Full Paper PDF

Create a free account to open full-text PDFs.

Study Details

References (4)

Papers cited by this study that are also in Blossom

How could MDMA (ecstasy) help anxiety disorders? A neurobiological rationale

Johansen, P. Ø., Krebs, T. S. · Journal of Psychopharmacology (2009)

Gender differences in the subjective effects of MDMA

Liechti, M. E., Gamma, A., Vollenweider, F. X. · Psychopharmacology (2001)

349 cited

Cited By (88)

Papers in Blossom that reference this study

The conceptual framework for the therapeutic approach used in phase 3 trials of MDMA-assisted therapy for PTSD

O'Donnell, K., Okano, L., Alpert, M. et al. · Frontiers in Psychology (2024)

23 cited
Side-effects of mdma-assisted psychotherapy: a systematic review and meta-analysis

Colcott, J., Guerin, A. A., Carter, O. et al. · Neuropsychopharmacology (2024)

Effects of MDMA-assisted therapy for PTSD on self-experience

van der Kolk, B., Wang, J. B., Yehuda, R. et al. · PLOS ONE (2024)

Preliminary evidence for the importance of therapeutic alliance in MDMA-assisted psychotherapy for posttraumatic stress disorder

Zeifman, R. J., Kettner, H., Ross, S. et al. · European Journal of Psychotraumatology (2024)

27 cited
Show all 88 papers
Dark loops: contagion effects, consistency and chemosocial matrices in psychedelic-assisted therapy trials

Noorani, T. N., Bedi, G., Muthukumaraswamy, S. · Psychological Medicine (2023)

21 cited
Dosing and Therapeutic Conduct in Administration Sessions in Substance-Assisted Psychotherapy: A Systematized Review

Thal, S. B., Wieberneit, M., Sharbanee, J. M. et al. · Journal of Humanistic Psychology (2023)

4 cited
Can psychedelics enhance group psychotherapy? A discussion on the therapeutic factors

Ponomarenko, P., Seragnoli, F., Calder, A. et al. · Journal of Psychopharmacology (2023)

Adverse events in clinical treatments with serotonergic psychedelics and MDMA: A mixed-methods systematic review

Breeksema, J. J., Kuin, B. W., Kamphuis, J. et al. · Journal of Psychopharmacology (2022)

9 cited
MDMA and memory, addiction, and depression: dose-effect analysis

Pantoni, M. M., Kim, J. L., Van Alstyne, K. R. et al. · Psychopharmacology (2022)

A randomized controlled trial of 3,4-methylenedioxymethamphetamine (MDMA) and fear extinction retention in healthy adults

Maples-Keller, J. L., Norrholm, S. D., Burton, M. et al. · Journal of Psychopharmacology (2022)

42 cited
The clinical pharmacology and potential therapeutic applications of 5-methoxy-N,N-dimethyltryptamine (5-MeO-DMT)

Reckweg, J., Uthaug, M. V., Szabo, A. et al. · Journal of Neurochemistry (2022)

Psychedelic Group Therapy

Gasser, P. · Current Topics in Behavioral Neurosciences (2022)

Great Expectations: Recommendations for improving the methodological rigor of psychedelic clinical trials

Aday, J. S., Heifets, B. D., Pratscher, S. D. et al. · Psychopharmacology (2021)

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

Smith, K. W., Sicignano, D. J., Hernandez, A. V. et al. · Journal of Clinical Pharmacology (2021)

A Systematic Review of the MDMA Model to Address Social Impairment in Autism

Chaliha, D., Mamo, J. C., Albrecht, M. et al. · Current Neuropharmacology (2021)

3 cited
Sleep Quality Improvements After MDMA-Assisted Psychotherapy for the Treatment of Posttraumatic Stress Disorder

Ponte, L., Jerome, L., Hamilton, S. et al. · Journal of Traumatic Stress (2021)

22 cited
A Qualitative Study of Intention and Impact of Ayahuasca Use by Westerners

Bathje, G. J., Fenton, J., Pillersdorf, D. et al. · Journal of Humanistic Psychology (2021)

18 cited
Prediction of MDMA response in healthy humans: a pooled analysis of placebo-controlled studies

Studerus, E., Vizeli, P., Harder, S. et al. · Journal of Psychopharmacology (2021)

50 cited
Psychedelic Harm Reduction and Integration: A Transtheoretical Model for Clinical Practice

Palhano-Fontes, F., Gorman, I., Nielson, E. M. et al. · Frontiers in Psychology (2021)

Psychedelic Medicines in Major Depression: Progress and Future Challenges

Bouso, J. C., Ona, G., Dos Santos, R. G. et al. · Advances in Experimental Medicine and Biology (2021)

The cost-effectiveness of MDMA-assisted psychotherapy for the treatment of chronic, treatment-resistant PTSD

Marseille, E., Kahn, J. G., Yazar-Klosinski, B. et al. · PLOS ONE (2020)

The Emerging Role of Psilocybin and MDMA in the Treatment of Mental Illness

Gill, H., Gill, B., Chen-Li, D. et al. · Expert Review of Neurotherapeutics (2020)

A Meta-Analysis of Placebo-Controlled Trials of Psychedelic-Assisted Therapy

Luoma, J. B., Chwyl, C., Bathje, G. J. et al. · Journal of Psychoactive Drugs (2020)

168 cited
Me, myself, bye: regional alterations in glutamate and the experience of ego dissolution with psilocybin

Mason, N. L., Kuypers, K. P. C., Reckweg, J. et al. · Neuropsychopharmacology (2020)

73 cited
In vivo effects of 3,4-methylenedioxymethamphetamine (MDMA) and its deuterated form in rodents: Drug discrimination and thermoregulation.

Berquist, M. D., Leth-Petersen, S., Kristensen, J. L. et al. · Drug and Alcohol Dependence (2020)

5 cited
Posttraumatic Growth After MDMA-Assisted Psychotherapy for Posttraumatic Stress Disorder

Gorman, I., Belser, A. B., Jerome, L. et al. · Journal of Traumatic Stress (2020)

31 cited
A proof-of-principle study of the short-term effects of 3,4-methylenedioxymethamphetamine (MDMA) on tinnitus and neural connectivity

Searchfield, G. D., Poppe, T. N. E. R., Durai, M. et al. · International Journal of Neuroscience (2020)

7 cited
Efficacy of 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy for posttraumatic stress disorder: A systematic review and meta-analysis.

Bahji, A., Forsyth, A., Groll, D. et al. · Progress in Neuro-Psychopharmacology and Biological Psychiatry (2020)

61 cited
Distinct acute effects of LSD, MDMA, and D-amphetamine in healthy subjects.

Holze, F., Vizeli, P., Müller, F. et al. · Neuropsychopharmacology (2019)

214 cited
Breakthrough for trauma treatment: safety and efficacy of MDMA-assisted psychotherapy compared to paroxetine and sertraline

Feduccia, A. A., Jerome, L., Yazar-Klosinski, B. et al. · Frontiers in Psychiatry (2019)

Effects of MDMA on attention to positive social cues and pleasantness of affective touch

Bershad, A. K., Mayo, L. M., Van Hedger, K. et al. · Neuropsychopharmacology (2019)

Greater empathy in MDMA users

Carlyle, M., Stevens, T., Fawaz, L. et al. · Journal of Psychopharmacology (2019)

Neuroimaging of chronic MDMA (“ecstasy”) effects: A meta-analysis

Müller, F., Brändle, R., Liechti, M. E. et al. · Neuroscience and Biobehavioral Reviews (2019)

Role of serotonin transporter and receptor gene variations in the acute effects of MDMA in healthy subjects

Vizeli, P., Meyer Zu Schwabedissen, H. E., Liechti, M. E. · ACS Chemical Neuroscience (2018)

Psychedelics promote structural and functional neural plasticity

Ly, C., Greb, A. C., Cameron, L. P. et al. · Cell Reports (2018)

MDMA-assisted psychotherapy for PTSD: are memory reconsolidation and fear extinction underlying mechanisms?

Feduccia, A. A., Mithoefer, M. C. · Progress in Neuro-Psychopharmacology and Biological Psychiatry (2018)

A Survey of American Psychiatrists’ Attitudes Toward Classic Hallucinogens

Barnett, B. S., Siu, W. O., Pope Jr, H. G. · Journal of Nervous and Mental Disease (2018)

Are Ecstasy Induced Serotonergic Alterations Overestimated For The Majority Of Users?

Szigeti, B., Winstock, A. R., Erritzoe, D. et al. · Journal of Psychopharmacology (2018)

Effects of N, N-Dimethyltryptamine on Rat Behaviors Relevant to Anxiety and Depression

Cameron, L. P., Benson, C. J., Dunlap, L. E. · ACS Chemical Neuroscience (2018)

Psychedelics: Where we are now, why we got here, what we must do

Belouin, S. J., Henningfield, J. E. · Neuropharmacology (2018)

Key interindividual determinants in MDMA pharmacodynamics

Papaseit, E., Torrens, M., Pérez-Mañá, C. et al. · Expert Opinion on Drug Metabolism and Toxicology (2018)

MDMA-Induced Dissociative State not Mediated by the 5-HT2A Receptor

Kuypers, K. P. C., Puxty, D. J., Ramaekers, J. G. et al. · Frontiers in Pharmacology (2017)

Therapeutic effect of increased openness: investigating mechanism of action in MDMA-assisted psychotherapy

Wagner, M. T., Mithoefer, M. C., Mithoefer, A. T. et al. · Journal of Psychopharmacology (2017)

147 cited
Acute effects of LSD on amygdala activity during processing of fearful stimuli in healthy subjects

Mueller, F., Lenz, C., Dolder, P. C. et al. · Translational Psychiatry (2017)

Pharmacogenetics of ecstasy: CYP1A2, CYP2C19, and CYP2B6 polymorphisms moderate pharmacokinetics of MDMA in healthy subjects

Vizeli, P., Schmid, Y., Prestin, K. et al. · European Neuropsychopharmacology (2017)

Safety pharmacology of acute MDMA administration in healthy subjects

Vizeli, P., Liechti, M. E. · Journal of Psychopharmacology (2017)

Altered insula connectivity under MDMA

Walpola, I. C., Nest, T., Leor, R. et al. · Neuropsychopharmacology (2017)

The association of psychedelic use and opioid use disorders among illicit users in the United States

Pisano, V. D., Putnam, N. P., Kramer, H. M. et al. · Journal of Psychopharmacology (2017)

The effects of MDMA on socio-emotional processing: Does MDMA differ from other stimulants?

Bershad, A. K., Miller, M. A., Baggot, M. J. et al. · Journal of Psychopharmacology (2016)

Clinical Applications of Hallucinogens: A Review

Garcia-Romeu, A., Kersgaard, B., Addy, P. H. · Experimental and Clinical Psychopharmacology (2016)

174 cited
Novel psychopharmacological therapies for psychiatric disorders: psilocybin and MDMA

Grob, C. S., Mithoefer, M. C., Brewerton, T. D. · Lancet Psychiatry (2016)

MDMA-assisted therapy: A new treatment model for social anxiety in autistic adults

Danforth, A. L., Struble, C., Yazar-Klosinski, B. et al. · Progress in Neuro-Psychopharmacology and Biological Psychiatry (2016)

Neuroimaging in moderate MDMA use: A systematic review

Mueller, F., Lenz, C., Steiner, M. et al. · Neuroscience and Biobehavioral Reviews (2015)

Effects of MDMA on socioemotional feelings, authenticity, and autobiographical disclosure in healthy volunteers in a controlled setting

Baggot, M. J., Coyle, J. R., Siegrist, J. D. et al. · Journal of Psychopharmacology (2015)

2 cited
Intimate insight: MDMA changes how people talk about significant others

Baggot, M. J., Kirkpatrick, M. G., Bedi, G. et al. · Journal of Psychopharmacology (2015)

53 cited
Acute Effects of the Novel Psychoactive Drug 2C-B on Emotions

González, D., Torrens, M., Farré, M. · BioMed Research International (2015)

56 cited
Effects of ecstasy on cooperative behaviour and perception of trustworthiness: A naturalistic study

Stewart, L., Ferguson, B., Morgan, C. J. A. et al. · Journal of Psychopharmacology (2014)

MDMA decreases the effects of simulated social rejection

Frye, C. G., Wardle, M. C., Norman, G. J. et al. · Pharmacology Biochemistry and Behavior (2014)

Your Personal Research Library

Go Pro to save papers, add notes, rate studies, and organize your research into custom shelves.