PTSD: MDMA-assisted therapy is more effective for PTSD than therapy alone
By Hannah Hartmann. This article was initially published in our Concussion Update newsletter; please consider subscribing.
Research published in Nature Medicine by Mitchell and colleagues found that methylenedioxymethamphetamine-assisted manualized inner-directed therapy (MDMA-AT) is a more effective treatment than manualized inner-directed therapy alone for improving moderate to severe post-traumatic stress disorder (PTSD). This finding may be due to the fact that MDMA is a psychoactive drug that encourages positive feelings while reducing the strength of emotional responses to triggering stimuli. The study authors also note that it is a historic milestone for psychedelic treatment studies that, in their study, “participants who identified as ethnically or racially diverse encompassed approximately half of the study sample.“
PTSD includes a collection of debilitating emotional and physical symptoms that develop as a result of a traumatic experience. First responders, military personnel, veterans, and victims of chronic sexual abuse have the highest risk of developing PTSD. However, any occurrence of a traumatic event, including injuries like concussions, has the potential to develop into PTSD. Previous research articles have consistently found overlapping symptoms between PTSD and persisting symptoms after a concussion.
The researchers conducted a multi-site, randomized, double-blinded study that compared the effectiveness of the MDMA-AT with that of a placebo plus therapy group. Results found that 86.5% of the participants in the MDMA-AT group showed a “clinically meaningful benefit” (a reduction in their symptoms) at 18 weeks after baseline, compared to 69% in the placebo plus therapy group. In addition, 71.2% of participants in the MDMA-AT group no longer met the diagnostic criteria for PTSD, compared to 47.6% in the placebo plus therapy group. This study shows that MDMA-assisted psychotherapy is a more effective treatment than therapy alone.
However, because 69% of the placebo plus therapy group had clinically meaningful benefits from the manualized inner-directed therapy that the researchers developed for use with MDMA, the authors posit that this effect “could suggest the standalone value of the manualized inner-directed therapy that was developed for use with MDMA.” The authors identify a need for future “head-to-head” studies to compare the effectiveness of this new therapy with that of cognitive behavioral therapy and prolonged exposure therapy, which are the current first-line treatments for PTSD.
