PTSD and alcohol use disorder often co-occur in trauma-exposed patients, creating a cycle where PTSD symptoms drive heavy drinking and vice versa. No FDA-approved medications exist specifically for this comorbidity; patients receive treatments approved for each disorder separately or off-label, which have limited efficacy. Emerging research suggests the psychedelic drug MDMA, used with psychotherapy, may be effective. This review examines current pharmacotherapies and MDMA-integrative psychotherapy for PTSD and AUD both individually and together, and discusses future directions for psychedelic-integrative therapy in treating this comorbidity.
Posttraumatic stress disorder and alcohol use disorder frequently co-occur and lead to more severe symptoms, higher suicide risk, and poorer treatment outcomes. MDMA-assisted therapy shows promise; the FDA designated it a Breakthrough Therapy for PTSD based on six Phase 2 trials. This manuscript describes the design of the first open-label trial of MDMA-AT for military veterans with both PTSD and AUD, enrolling 12 participants. The study includes neuroimaging and biomarker measures to assess brain changes and neuroinflammation before and after treatment. The authors detail the complex clinical and regulatory processes involved in setting up the trial, aiming to establish standardized protocols and outcomes for future FDA approval.