Therapeutic role of psilocybin and 3,4-methylenedioxymethamphetamine in trauma: A literature review

Psilocybin and MDMA, designated breakthrough therapies by the FDA in 2017 for post-traumatic stress disorder and treatment-resistant depression, are being studied for rapid improvement in psychiatric conditions. Classic psychedelics like psilocybin, LSD, and ayahuasca, along with non-classic drugs such as MDMA and ketamine, show potential for treating trauma and depressive disorders. This review focuses on psilocybin and MDMA in psychedelic-assisted therapy (PAT), as they compose most of the literature. It discusses their current and future uses, emphasizing their role in trauma and related comorbidities, and suggests future research directions including wearables, standardized symptom scales, therapy styles, and adverse drug reaction assessment.

Study at a glance

Abstract

With the Food and Drug Administration designation in 2017 of 3,4-methylenedioxymethamphetamine (MDMA) as a breakthrough therapy in post-traumatic stress disorder and psilocybin in treatment-resistant depression, psychedelic drugs have continued to garner the attention of researchers and clinicians for their promise of unmatched, rapid improvement in a multitude of psychiatric conditions. Classic psychedelic drugs including psilocybin, lysergic acid diethylamide, and ayahuasca, as well as non-classic drugs such as MDMA and ketamine, are currently being investigated for a potential therapeutic role in trauma, depressive disorders, and other psychopathologies. However, psilocybin and MDMA each have a functional profile well-suited for integration with psychotherapy. The present review focuses on psilocybin and MDMA in psychedelic-assisted therapy (PAT), as these studies compose most of the literature pool. In this review, we discuss the current and future uses of psychedelic drugs, with an emphasis on the role of MDMA and psilocybin in PAT in the setting of trauma and related comorbidities on the efficacy of psychedelic drugs across multiple psychiatric disorders. The article concludes with thoughts for future research, such as incorporating wearables and standardization of symptom scales, therapy styles, and assessment of adverse drug reactions.