Refractory Post-Traumatic Stress Disorder: Is 3,4-Methylenedioxymethamphetamine (MDMA) the answer?

Refractory Post-Traumatic Stress Disorder: Is 3,4-Methylenedioxymethamphetamine (MDMA) the answer?



Background: Treatment-resistant, refractory, chronic post-traumatic stress disorder (PTSD) is now considered a major public health problem for which current treatments are only found to be mild to moderately effective. Ineffective treatment of chronic PTSD leads to depression, anxiety disorders, substance use disorder and other comorbid conditions. 3,4-Methylenedioxymethamphetamine (MDMA), also known as ecstasy or molly, is a psychoactive substance primarily used as a recreational drug. Multiple phase 2 clinical trials studying the efficacy of MDMA in treatment-resistant, refractory, chronic PTSD have shown promising results, demonstrating long-term benefits with no clinically significant side effects when compared to current standard of care treatment.

Purpose/Objectives: The aim of this literature review is to comprehensively assess previous data and research on the effectiveness of MDMA-assisted psychotherapy for chronic, refractory PTSD to assist in future practice in management of this aforementioned disorder.

Methods: We used PubMed to explore the safety and efficacy of MDMA-assisted psychotherapy in patients with chronic PTSD compared to current treatments, as well as to determine any related long-term impact or sequelae.

Results: Evidence shows that MDMA-assisted psychotherapy is successful in treating patients suffering from treatment- resistant PTSD and has shown clinically significant relief in patients’ symptoms that were refractory to other medications. Multiple studies have shown varying results, but most agree that MDMA-assisted psychotherapy in chronic PTSD patients resulted in a significant improvement in the patients’ Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) scores, without leading to adverse drug related effects, if safely administered in a clinical setting. Preliminary research has also shown long-term benefits of MDMA-assisted psychotherapy in this regard.

Conclusions: Overall, our review concluded that the results of MDMA-assisted psychotherapy is very promising and believe the ongoing phase 3 clinical trials will help shape the future of managing chronic refractory PTSD and ultimately moving towards finding a cure for this much debilitating chronic disease.

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