Efficacy of Psychoactive Drugs for the Treatment of Posttraumatic Stress Disorder: A Systematic Review of MDMA, Ketamine, LSD and Psilocybin

Summary

MDMA, a psychoactive drug, shows moderate evidence in clinical psychology for treating PTSD when combined with psychotherapy. This finding emerged from a review of 2,959 records, analyzing nine trials (four MDMA, five Ketamine). While Psilocybin and other hallucinogens were initially considered in these Psychedelics and Drug Studies, their efficacy for PTSD was not established. Ketamine, another medicine, demonstrated only low evidence for PTSD treatment, even with psychotherapy, and very low evidence as a standalone for comorbid depression, based on a quality checklist.

Abstract

The aim of this systematic review was to examine the efficacy of MDMA, ketamine, LSD, and psilocybin for the treatment of posttraumatic stress disorder (PTSD). A search of four databases for English language, peer-reviewed literature published from inception to 18th October 2019 yielded 2,959 records, 34 of which were screened on full-text. Observational studies and RCTs which tested the efficacy of MDMA, ketamine, LSD, or psilocybin for reducing PTSD symptoms in adults, and reported changes to PTSD diagnosis or symptomatology, were included. Nine trials (five ketamine and four MDMA) met inclusion criteria. Trials were rated on a quality and bias checklist and GRADE was used to rank the evidence. The evidence for ketamine as a stand-alone treatment for comorbid PTSD and depression was ranked "very low", and the evidence for ketamine in combination with psychotherapy as a PTSD treatment was ranked "low". The evidence for MDMA in combination with psychotherapy as a PTSD treatment was ranked "moderate".

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