PTSDMDMA

Posttraumatic Growth After MDMA-Assisted Psychotherapy for Posttraumatic Stress Disorder

Pooled data from three Phase 2 triple‑blind crossover trials show that MDMA‑assisted psychotherapy (75–125 mg) produced significantly greater posttraumatic growth (Hedges’ g = 1.14) and larger PTSD symptom reductions (Hedges’ g = 0.88) at the primary endpoint versus placebo/low‑dose control. These gains persisted to 12‑month follow‑up—with higher PTG, lower symptom scores and 67.2% no longer meeting PTSD criteria—suggesting PTG may be a meaningful mechanism of treatment effect.

Authors

  • Berra Yazar-Klosinski
  • Lisa Jerome
  • Amy Emerson

Published

Journal of Traumatic Stress
meta Study

Abstract

3,4‐Methylenedioxymethamphetamine (MDMA)–assisted psychotherapy for posttraumatic stress disorder (PTSD) has been shown to significantly reduce clinical symptomatology, but posttraumatic growth (PTG), which consists of positive changes in self‐perception, interpersonal relationships, or philosophy of life, has not been studied with this treatment. Participant data (n = 60) were pooled from three Phase 2 clinical studies employing triple‐blind crossover designs. Participants were required to meet DSM‐IV‐R criteria for PTSD with a score higher than 50 on the Clinician‐Administered PTSD Scale (CAPS‐IV) as well as previous inadequate response to pharmacological and/or psychotherapeutic treatment. Data were aggregated into two groups: an active MDMA dose group (75–125 mg of MDMA; n = 45) or placebo/active control (0–40 mg of MDMA; n = 15). Measures included the Posttraumatic Growth Inventory (PTGI) and the CAPS‐IV, which were administered at baseline, primary endpoint, treatment exit, and 12‐month follow‐up. At primary endpoint, the MDMA group demonstrated more PTG, Hedges’ g = 1.14, 95% CI [0.49, 1.78], p < .001; and a larger reduction in PTSD symptom severity, Hedges’ g = 0.88, 95% CI [−0.28, 1.50], p < .001, relative to the control group. Relative to baseline, at the 12‐month follow‐up, within‐subject PTG was higher, p < .001; PTSD symptom severity scores were lower, p < .001; and two‐thirds of participants (67.2%) no longer met criteria for PTSD. MDMA‐assisted psychotherapy for PTSD resulted in PTG and clinical symptom reductions of large‐magnitude effect sizes. Results suggest that PTG may provide a new mechanism of action warranting further study.

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Research Summary of 'Posttraumatic Growth After MDMA-Assisted Psychotherapy for Posttraumatic Stress Disorder'

Introduction

Gorman and colleagues situate this study in the context of growing evidence that MDMA-assisted psychotherapy reduces PTSD symptom severity, including pooled Phase 2 data showing large effects and the FDA's Breakthrough Therapy designation for MDMA-assisted psychotherapy. They note that most PTSD trials focus on symptom reduction and functional impairment, while relatively little attention has been paid to positive psychological changes following trauma. Posttraumatic growth (PTG) — positive change in self-perception, interpersonal relationships, or life philosophy — is measured by the Posttraumatic Growth Inventory (PTGI), which captures five factors: relating to others, new possibilities, personal strength, spiritual change, and appreciation of life. Previous intervention studies have produced mixed evidence for treatment-related increases in PTG, and no published trials had examined PTG in the context of medication-assisted psychotherapy prior to this work. This exploratory secondary analysis pooled participant-level data from three Phase 2, triple-blind crossover trials to test whether MDMA-assisted psychotherapy influences PTG while also reducing PTSD symptoms. The investigators hypothesised that active MDMA doses combined with manualised psychotherapy would increase PTG and that changes in PTG would correlate with reductions in PTSD severity. Assessing PTG in this clinical-trial context was presented as a novel contribution to understanding possible mechanisms of action for MDMA-assisted psychotherapy.

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Study Details

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References (11)

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Posttraumatic Growth After MDMA-Assisted... — Research Summary & Context | Blossom