MDMA-assisted psychotherapy for PTSD in adolescents – rationale, potential, risks, and considerations
Samuli Kangaslampi, Josjan Zijlmans
preprint DOI: 10.31234/osf.io/k3hz6
Summary
MDMA-assisted psychotherapy (MDMA-AP) may be a promising treatment for adolescents with posttraumatic stress disorder (PTSD), as it could help reduce avoidance and improve trauma processing. The rationale for its use includes adaptations such as enhancing motivation, building a strong therapeutic alliance, and involving family in treatment. However, potential risks specific to adolescents must be considered, and clinical trials are needed to assess the safety and effectiveness of MDMA-AP for this population.
Study at a glance
| Population | adolescents with posttraumatic stress disorder (PTSD) |
|---|---|
| Key finding | MDMA-AP holds potential for adolescents suffering from PTSD, but clinical trials are necessary to evaluate its safety and effectiveness. |
Abstract
3,4-methylenedioxymetamphetamine(MDMA)-assisted psychotherapy (MDMA-AP) is a proposed treatment for posttraumatic stress disorder (PTSD) that may be approved for adults soon. PTSD is also common among trauma-exposed adolescents, and current treatments leave much room for improvement. We present a rationale for considering MDMA-AP for treating PTSD among adolescents. Evidence suggests that as an adjunct to therapy, MDMA may reduce avoidance and enable trauma processing, strengthen therapeutic alliance, enhance extinction learning and trauma-related reappraisal, and hold potential beyond PTSD symptoms. Drawing on existing trauma-focused treatments, we suggest possible adaptations to MDMA-AP for use with adolescents, focusing on 1) reinforcing motivation, 2) the development of a strong therapeutic alliance, 3) additional emotion and behavior management techniques, 4) more directive exposure-based methods during MDMA sessions, 5) more support for concomitant challenges and integrating treatment benefits, and 6) involving family in treatment. We then discuss potential risks particular to adolescents, including physical and psychological side effects, toxicity, misuse potential, and ethical issues.We argue that MDMA-AP holds potential for adolescents suffering from PTSD. Instead of off-label use or extrapolating from adult studies, clinical trials should be carried out to determine whether MDMA-AP is safe and effective for PTSD among adolescents.