MDMA-assisted psychotherapy rapidly decreases PTSD symptoms, dissociation, depression, and functional disability : a systematic review and meta-analysis

Current treatment of posttraumatic stress disorder (PTSD) targets 5-HT receptors with selective serotonin reuptake inhibitors (SSRIs) in combination with psychotherapy. It is ineffective in many cases. Four decades have passed without any clinically meaningful alternative. Here we show MDMA (3, 4-methylenedioxymethamphetamine)-assisted therapies are effective in reducing PTSD symptoms, dissociation severity, comorbid depression, and functional disability. A systematic literature search identified randomised control trials (RCTs) in adult participants with treatment-resistant PTSD. The result was streamlined using Covidence systematic review software. A random-effects meta-analysis was performed for each dependent variable using Review Manager (RevMan). The protocol followed the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines. A total of six RCTs, constituting 169 participants, were included. MDMA-assisted psychotherapy decreases PTSD symptoms, MD = -19.37, 95% CI [-29.02, -9.73], p<.001; dissociation severity, MD = -9.75, 95% CI [ -13.39, -6.12], p<.001; comorbid depression, MD = -11.13, 95% CI [-19.35, -2.92], p = 0.008; sleep disturbance MD = -3.67, 95% CI [ -7.70, 0.36], p = 0.07; and increases daily functioning, SMD = 0.92, 95% CI [0.10, 1.73], p = 0.03. These data suggest MDMA-assisted therapies is effective for PTSD and indicates there is potential for clinical translation.