Treating posttraumatic stress disorder and alcohol use disorder comorbidity: Current pharmacological therapies and the future of MDMA-integrated psychotherapy.
Journal of psychopharmacology (Oxford, England) – December 01, 2023
Source: PubMed
Summary
Psychedelics like MDMA show promise in treating the challenging combination of posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD), which often occur together. Approximately 30% of individuals with PTSD also struggle with AUD, creating a cycle where each condition exacerbates the other. Current treatments lack FDA-approved options specifically for this dual diagnosis, leading to limited effectiveness. Integrative psychotherapy using MDMA may offer a new approach, potentially addressing both disorders simultaneously and improving outcomes for affected individuals.
Abstract
Posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) frequently co-occur in patients who have experienced trauma. This comorbidity leads to a vicious cycle where PTSD symptoms beget heavy drinking and vice versa. There are no FDA-approved medications to treat PTSD-AUD; therefore, individuals suffering from this comorbidity are treated with medication approved to treat the disorders separately or with off-label pharmacological interventions. However, these medications are limited in their efficacy for treating PTSD-AUD comorbidity. Emerging research on the nonclassical psychedelic drug 3,4-methylenedioxymethamphetamine (MDMA) suggests that it may be an effective drug used in conjunction with psychotherapy. The following reviews the current research for clinical pharmacotherapies, as well as MDMA-integrative psychotherapy as they pertain to PTSD and AUD in isolation and co-occurrence. Future directions for the role of psychedelic-integrative therapy for the treatment of this comorbidity are discussed.