Towards therapeutic paths with mindfulness meditation–based and psychedelics assisted psychotherapies in PTSD: Randomized controlled trials systematic review and meta-analysis
Solène Maeder, Cherine Fahim, Chantal Martin-söelch
Cortica December 15, 2025 Peer reviewed DOI: 10.26034/cortica.2025.8925 via OpenAlex
Summary
Mindfulness meditation-based interventions (MMBIs) and psychedelic-assisted psychotherapies (PAP) both significantly reduce PTSD symptoms in adults. MMBIs showed a moderate effect size of 0.45, while PAP had a slightly larger effect size of 0.54, with MDMA outperforming ketamine. Although PAP demonstrated lower risk of bias and tighter confidence intervals, MMBIs are easier to disseminate. Future studies should explore long-term effects, adverse events, and the role of altered states of consciousness.
Study at a glance
| Design | systematic review |
|---|---|
| Population | adults with PTSD |
| Key finding | Both mindfulness meditation-based interventions and psychedelic-assisted psychotherapies are efficacious in reducing PTSD symptoms among adults. |
Abstract
The purpose of this study was to compare mindfulness meditation-based interventions (MMBIs) and psychedelic-assisted psychotherapies (PAP) in PTSD and examine altered-state mediators as a shared mechanism. Following PRISMA 2020 guidelines, PubMed, Web of Science, and EBSCOhost were systematically searched for randomized controlled trials (RCTs) published through January 2024. Trials reporting post-treatment changes in validated PTSD symptom measures were included, focusing on two intervention categories: MMBIs (n = 13 RCTs) and PAP (n = 9 RCTs). Standardized mean differences (SMD) were calculated under a random-effects model, with 95% confidence intervals (CIs). MMBIs produced a significant, moderate effect on PTSD symptoms (SMD=0.45, 95% CI [0.27, 0.63]; p < 0.001). PAP also demonstrated a moderate effect size (SMD=0.54, 95% CI [0.32, 0.76]; p < 0.001), with MDMA displaying slightly stronger outcomes than ketamine. PAP studies generally showed tighter confidence intervals and lower risk of bias compared to MMBI trials. Heterogeneity varied, but subgroup analyses indicated consistent effects across intervention types. Both MMBIs and PAP are efficacious in reducing PTSD symptoms among adults. While PAP appears to yield a marginally larger effect size, MMBIs offer practical advantages due to ease of dissemination. Future research should address long-term efficacy, adverse events, and culturally diverse populations. The role of altered states of consciousness in both interventions also warrant closer investigation, potentially illuminating mechanisms underlying therapeutic gains.