Frontiers in psychiatry
January 1, 2025
Dimitri Perivoliotis, Kayla Knopp, Shannon Remick et al.
2 citations
Set and setting—the mindset a person brings to therapy and the environment in which it occurs—are foundational to MDMA-assisted therapy for PTSD and critically influence its efficacy. Drawing on experience conducting clinical trials in the Veterans Health Administration, this article describes advantages and challenges of implementing this intervention in large healthcare systems. Specific, practical suggestions are offered for optimizing set and setting from both participant and clinician perspectives, aiming to leverage opportunities and adapt to challenges. These recommendations are intended to inform future research and potential clinical implementation efforts in traditional healthcare settings.
Psychedelic medicine (New Rochelle, N.Y.)
August 1, 2025
Kush V Bhatt, Jason N Compton, Em Ellerman et al.
1 citation
Mystical experiences, which may have therapeutic value, occurred in about 17-18% of ketamine treatments among 60 veterans with treatment-resistant depression. In those receiving esketamine, more treatment sessions were linked to higher mystical experience scores; in those receiving racemic ketamine, higher doses were linked to higher scores. The findings suggest that ketamine can occasion mystical experiences in this population.
September 7, 2025
Mathew Herbert, Brian H. Blanco, Dimitri Perivoliotis et al.
preprint
MDMA-assisted psychotherapy shows promise for treating PTSD, but the FDA rejected its current form due to concerns about standardization and empirical grounding of the psychotherapy methods. Acceptance and Commitment Therapy (ACT), an evidence-based cognitive behavioral therapy, is proposed as a well-suited alternative to pair with MDMA. The subjective effects of MDMA directly support key ACT processes; ACT methods could prepare patients for MDMA administration, guide therapists during sessions, and help integrate MDMA experiences to improve functioning and quality of life. ACT offers a scalable, structured yet flexible framework for a new PTSD treatment approach.