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Posttraumatic Growth After MDMA‐Assisted Psychotherapy for Posttraumatic Stress Disorder

Ingmar Gorman, Alexander Belser, Lisa Jerome, Colin Hennigan, Ben Shechet, Scott Hamilton, Berra Yazar‐klosinski, Amy Emerson, Allison A. Feduccia

Journal of Traumatic Stress February 19, 2020 DOI: 10.1002/jts.22479 via OpenAlex

Summary

AI-generated from the abstract

MDMA-assisted psychotherapy for posttraumatic stress disorder (PTSD) not only reduces symptoms but also promotes posttraumatic growth (PTG)—positive changes in self-perception, relationships, and life philosophy. Pooled data from three phase 2 clinical trials with 60 participants showed that those receiving active MDMA (75–125 mg) had significantly more PTG and larger reductions in PTSD symptom severity at the primary endpoint compared to the control group (0–40 mg MDMA). At 12-month follow-up, PTG remained higher, symptom severity lower, and two-thirds of participants no longer met PTSD criteria. These large-magnitude effects suggest PTG may be a new mechanism of action for this treatment.

Study at a glance

Characteristics Pooled analysis of three phase 2 clinical trials with triple-blind crossover designs Peer reviewed
Sample size 60
Population Adults meeting DSM-IV-R criteria for PTSD with CAPS-IV score above 50 and prior inadequate response to treatment
Dose 75–125 mg of MDMA (active), 0–40 mg of MDMA (placebo/active control)
Duration Primary endpoint (timing not specified), treatment exit, and 12-month follow-up
Topics MDMA
Keywords Placebo Posttraumatic stress Posttraumatic growth Psychiatry
Citations 43
Key finding MDMA-assisted psychotherapy produced large-magnitude increases in posttraumatic growth and reductions in PTSD symptom severity, with two-thirds of participants no longer meeting PTSD criteria at 12-month follow-up.

Abstract

Abstract 3,4‐Methylenedioxymethamphetamine (MDMA)–assisted psychotherapy for posttraumatic stress disorder (PTSD) has been shown to significantly reduce clinical symptomatology, but posttraumatic growth (PTG), which consists of positive changes in self‐perception, interpersonal relationships, or philosophy of life, has not been studied with this treatment. Participant data ( n = 60) were pooled from three Phase 2 clinical studies employing triple‐blind crossover designs. Participants were required to meet DSM‐IV‐R criteria for PTSD with a score higher than 50 on the Clinician‐Administered PTSD Scale (CAPS‐IV) as well as previous inadequate response to pharmacological and/or psychotherapeutic treatment. Data were aggregated into two groups: an active MDMA dose group (75–125 mg of MDMA; n = 45) or placebo/active control (0–40 mg of MDMA; n = 15). Measures included the Posttraumatic Growth Inventory (PTGI) and the CAPS‐IV, which were administered at baseline, primary endpoint, treatment exit, and 12‐month follow‐up. At primary endpoint, the MDMA group demonstrated more PTG, Hedges’ g = 1.14, 95% CI [0.49, 1.78], p < .001; and a larger reduction in PTSD symptom severity, Hedges’ g = 0.88, 95% CI [−0.28, 1.50], p < .001, relative to the control group. Relative to baseline, at the 12‐month follow‐up, within‐subject PTG was higher, p < .001; PTSD symptom severity scores were lower, p < .001; and two‐thirds of participants (67.2%) no longer met criteria for PTSD. MDMA‐assisted psychotherapy for PTSD resulted in PTG and clinical symptom reductions of large‐magnitude effect sizes. Results suggest that PTG may provide a new mechanism of action warranting further study.

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