For posttraumatic stress disorder (PTSD), MDMA-assisted psychotherapy (MDMA-AP) shows larger treatment effects than prolonged exposure (PE) therapy, the current standard. A meta-analysis comparing two MDMA-AP clinical trials with several PE trials found MDMA-AP had larger effect sizes for clinician-observed outcomes (Hedges' g = 1.17 vs. 1.08) and patient self-report outcomes (Hedges' g = 0.87 vs. 0.77). MDMA-AP also had a considerably lower dropout rate than PE. These results suggest MDMA-AP offers a promising alternative for PTSD treatment, especially for patients who find PE intolerable or ineffective.
Among U.S. Special Operations Forces Veterans who completed a psychedelic treatment program with ibogaine and 5-methoxy-N,N-dimethyltryptamine in Mexico between 2017 and 2019, retrospective reports showed very large reductions in suicidal ideation, cognitive impairment, PTSD symptoms, depression, and anxiety from 30 days before to 30 days after treatment, along with a large increase in psychological flexibility. Increased psychological flexibility was strongly linked to reduced cognitive impairment and mental health symptoms. Most participants rated the experience among the top five most personally meaningful, spiritually significant, and psychologically insightful experiences of their lives. The findings are preliminary due to the retrospective, self-report, non-randomized design.