This interventional controlled study (n=20) will evaluate GPM-Complex psychotherapy with or without 2–5 MDMA-assisted sessions (initial 80 mg with optional 40 mg supplemental dose) for treating PTSD in individuals with co-occurring BPD.
Participants undergo a six-week pre-treatment module of one-hour weekly individual GPM-Complex sessions for psychoeducation, treatment planning and, for the MDMA arm, preparatory sessions. MDMA sessions are oral, delivered in a dedicated space with two therapists (one psychiatrist prescriber and one DBT-experienced co-therapist) and last up to eight hours.
Between two and five MDMA sessions are offered over a six-month course; dosing is individualised with a standard starting dose of 80 mg plus an optional 40 mg supplemental dose. Post-MDMA integration sessions continue weekly as part of GPM-Complex and outcomes are assessed during treatment and at 3 and 6 months post-discharge.
Comparator participants receive the same GPM-Complex psychotherapy schedule without MDMA. The study focuses on clinical effectiveness and safety within a public mental health service setting.
GPM-Complex plus 2–5 MDMA-assisted sessions (individualised; 1-month minimum between sessions).
Initial 80 mg with optional 40 mg supplemental dose; subsequent session dosing individualised per clinician judgement.
GPM-Complex psychotherapy: one-hour weekly pre-treatment module (6 weeks), preparatory sessions, and weekly post-MDMA integration sessions; sessions delivered by two therapists (one psychiatrist prescriber + co-therapist).
GPM-Complex psychotherapy without MDMA sessions; weekly one-hour sessions for six months.
GPM-Complex psychotherapy: one-hour weekly for six months; matched to MDMA arm on sex, age, education and clinical presentation.