Frontiers in Psychiatry
July 15, 2023
M. Kati Lear, Sarah M. Smith, Brian Pilecki et al.
14 citations
An open-label pilot study will test MDMA-assisted therapy for social anxiety disorder. Twenty participants with moderate-to-severe generalized social anxiety will be randomly assigned to immediate or delayed treatment. The immediate group receives three preparation sessions, two MDMA medicine sessions, and six integration sessions over about 16 weeks. The primary outcome is symptom reduction measured by the Liebowitz Social Anxiety Scale at post-treatment and 6-month follow-up. Secondary outcomes include changes in functional impairment, safety, and processes like shame, belongingness, self-concealment, and self-compassion. Results will inform the design of larger randomized controlled trials.
Frontiers in Psychiatry
September 27, 2021
Jason Luoma, M. Kati Lear
11 citations
Social anxiety disorder (SAD) often persists despite treatment, prompting interest in MDMA-assisted therapy (MDMA-AT) as an adjunct. A small randomized placebo-controlled trial in autistic adults showed encouraging results, but more research is needed. This review proposes how MDMA-AT may alter four disrupted systems in SAD: social anhedonia and reduced reward sensitivity, heightened threat perception, shame regulation, and dysfunctional interpersonal behaviors. The authors suggest MDMA-AT could enhance social motivation, increase feelings of safety and affiliation, reduce shame through self-transcendent emotions, and improve social skills, potentially boosting extinction learning and relationship quality.
June 4, 2026
Jason B Luoma, M. Kati Lear, Brian Pilecki et al.
preprint
MDMA-Assisted Therapy (MDMA-AT) produced a large reduction in social anxiety symptoms compared to a waitlist condition in adults with social anxiety disorder. In a randomized open-label trial of 20 participants, those receiving MDMA-AT showed an average decrease of 43.3 points on the Liebowitz Social Anxiety Scale after 16 weeks, while the waitlist group did not. Improvements also occurred in functioning, shame, acceptance, belongingness, self-concealment, and self-compassion. Adverse events were mild to moderate and temporary; no serious adverse events occurred. These preliminary findings suggest MDMA-AT is safe and feasible for social anxiety disorder and warrant further research.
Open Science Framework
January 1, 2026
Christina Chwyl, M. Kati Lear, Sunjeev Kamboj et al.
Self-compassion is thought to be important for mental health, especially for people with social anxiety disorder. MDMA-assisted therapy may work by increasing self-compassion. This study will examine whether trait self-compassion rises during treatment and whether self-compassion felt during MDMA dosing sessions leads to lasting changes. It will also test if changes in self-compassion relate to improvements in social anxiety, depression, shame, functioning, and belonging. Five specific aims are outlined to explore these relationships across two dosing sessions.
Jason B Luoma, M. Kati Lear, Kyong Yi et al.
preprint
A man in his late 30s with generalized social anxiety disorder (SAD) received MDMA-assisted therapy that included imaginal exposure to shame-related memories and in vivo social exposures during drug sessions, plus imagery rescripting and social activation homework. His symptoms and functional impairment, measured by the Leibowitz Social Anxiety Scale and Sheehan Disability Scale, showed significant reduction. He reported increased social engagement, less anxiety in social situations, and more self-compassion. The participant found exposures during MDMA sessions particularly impactful, allowing access to intrinsic desires for social connection. The authors suggest MDMA-assisted therapy with exposure techniques may be a promising treatment for SAD, warranting further research.