MDMA-assisted psychotherapy reduces PTSD symptoms more than control therapy. Patients receiving MDMA showed a greater reduction in Clinician-Administered PTSD Scale scores (difference of –22.03; 95% CI, –38.53 to –5.52) and were 3.65 times more likely to achieve clinically significant symptom reductions (95% CI, 2.39–5.57). They were also 2.10 times more likely to no longer meet PTSD criteria (95% CI, 1.37–3.21). Common side effects include bruxism, anxiety, jitteriness, headache, and nausea. The therapy is generally safe and well tolerated, but unregulated MDMA or use outside a controlled therapeutic setting carries considerable risks.
A meta-analysis of randomized controlled trials found that psychedelics, including LSD, increased the odds of patients with alcohol use disorder achieving abstinence or substantially reducing drinking compared to placebo. In double-blind, placebo-controlled trials, LSD (3 trials) produced an odds ratio of 1.99, and any psychedelic (4 trials) produced an odds ratio of 2.16. When including less rigorous controlled trials, the positive effect persisted. However, four of six trials had a high risk of bias and other methodological issues. One trial reported suicidal ideation and transient blood pressure increases, highlighting unresolved safety concerns. The evidence is promising but too weak for definitive conclusions; more rigorous trials are needed.