VeteransDepressive DisordersPTSDMDMA

MDMA Assisted Psychotherapy Decreases PTSD Symptoms, Dissociation, Functional Disability, and Depression: A Systematic Review and Meta-Analysis

This pre-print review and meta-analysis (2023) of randomised controlled trials (RCTs) assessed the effectiveness of MDMA-assisted psychotherapy (MDMA-AP/AT) for treating Post-Traumatic Stress Disorder (PTSD) and its impact on quality of life and physiological effects. The analysis found that MDMA-AP significantly improved dissociation, depression, and functional impairment in PTSD patients compared to controls, but not sleep quality.

Authors

  • Green, W. M.
  • Raut, S. B.
  • James, F. L. J.

Published

MedRvix
meta Study

Abstract

Post-Traumatic Stress Disorder (PTSD) causes broad impairments affecting quality of life. However, despite current treatment many people with PTSD do not fully recover. MDMA assisted psychotherapy has emerged as a new therapy for PTSD and its comorbidities. We aimed to analyse the current evidence for MDMA assisted psychotherapy in PTSD and associated quality of life, and physiological effects, by conducting a systematic review and metanalysis of randomised controlled trials. ClinicalTrials.gov, MEDLINE, PsycINFO, PsycARTICLES, and Cochrane Library database were searched from inception to July 2022. We included both published and unpublished randomized control trials comparing MDMA assisted psychotherapy (MDMA-AP) with control. Meta-analysis of primary and secondary outcome measures was performed using Review-Manager software. Effect sizes were calculated using Standardised Mean Difference for CAPS scores and Mean Difference for secondary measures. MDMA-AP significantly improves dissociation, depression, and functional impairment, compared to controls, but not sleep quality. This data supports the use of MDMA-AP for PTSD with an improvement found in PTSD core symptoms and quality of life measures. While these findings are limited by small samples sizes in currently available clinical trials, this study provides empirical evidence to support development of MDMA-AP in PTSD.

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Research Summary of 'MDMA Assisted Psychotherapy Decreases PTSD Symptoms, Dissociation, Functional Disability, and Depression: A Systematic Review and Meta-Analysis'

Introduction

PTSD is a common and often persistent disorder characterised by intrusive memories, avoidance, negative alterations in cognition and mood, and marked changes in arousal. Population surveys report a 12-month prevalence averaging 1.1% internationally and a lifetime prevalence around 8%, with substantially higher rates in some groups such as combat veterans. Despite evidence-based behavioural therapies (for example, cognitive processing or exposure therapies) and pharmacotherapies (SSRIs and SNRIs), a substantial proportion of patients remain symptomatic or develop chronic, treatment-resistant PTSD, creating a demand for novel treatments. This study set out to synthesise randomised controlled trial evidence on MDMA-assisted psychotherapy (MDMA-AP) for PTSD and its associated outcomes. Building on prior trials sponsored largely by the Multidisciplinary Association for Psychedelic Studies (MAPS) and mechanistic theories that MDMA may enhance cognitive flexibility, memory reactivation/reconsolidation, and fear extinction when combined with psychotherapy, Green and colleagues performed a systematic review and meta-analysis to quantify effects on clinician-rated PTSD severity (CAPS) and a set of secondary outcomes including dissociation, functional impairment, depression, sleep quality and physiological measures.

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Study Details

  • Study Type
    meta
  • Journal
  • Compound
  • Topics
  • APA Citation

    Green, W. M., Raut, S., James, F., Benedek, D., Ursano, R., & Johnson, L. (2023). MDMA Assisted Psychotherapy Decreases PTSD Symptoms, Dissociation, Functional Disability, and Depression: A Systematic Review and Meta-Analysis. https://doi.org/10.1101/2023.08.17.23293955

References (11)

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