MDMA-assisted therapy for severe PTSD may also reduce hazardous alcohol use without increasing illicit drug use. In a randomized trial, 90 adults with severe PTSD received either MDMA-assisted therapy or placebo plus therapy. Those in the MDMA group showed a greater reduction in alcohol use scores (average decrease of 1.02 points) compared to a slight increase in the placebo group (average increase of 0.40 points). Changes in drug use scores did not differ between groups. The findings suggest MDMA-assisted therapy could serve as an integrated treatment for co-occurring PTSD and alcohol or substance use disorders.
In a pooled analysis of two Phase 2 open-label trials and one Phase 3 randomized placebo-controlled trial of MDMA-assisted therapy for PTSD, no significant difference in symptom reduction was found between BIPOC and non-Hispanic White participants who received MDMA. Among those given placebo-assisted therapy, BIPOC participants showed a trend toward greater improvement than non-Hispanic Whites. Non-Hispanic Whites had significantly larger reductions in PTSD symptoms with MDMA than with placebo, but no such treatment difference emerged among BIPOC participants. Adverse events were mostly mild or moderate across all groups. The findings suggest MDMA-assisted therapy is effective and safe across ethnoracial groups, though subgroup sizes were imbalanced.
A mixed-methods case study examined whether a person of color with treatment-resistant PTSD would benefit from MDMA-assisted therapy (MDMA-AT) as much as participants in earlier, less diverse trials. The participant showed quantitative improvement in PTSD symptoms. An interpretative phenomenological analysis of therapy session transcripts revealed recurrent themes related to psychological mechanisms of symptom change, reduced PTSD symptoms, and additional positive and negative effects beyond symptom reduction. The authors discuss these themes and offer recommendations for addressing culturally relevant material during MDMA-AT.