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Self-experience in MDMA assisted therapy of PTSD

Bessel A. van der Kolk, Julie B. Wang, Rachel Yehuda, Leah Bedrosian, Allison Cooker, Charlotte Harrison, Michael Mithoefer, Berra Yazar-Klosinki, Amy Emerson, Rick Doblin

medRxiv Preprint Server January 3, 2023 preprint DOI: 10.1101/2023.01.03.23284143 via medRxiv

Summary

AI-generated from the abstract

A Phase 3 clinical trial tested MDMA-assisted therapy (MDMA-AT) against placebo with therapy for severe PTSD. 85% of participants reported early childhood trauma, linked to deficits in emotional coping. MDMA-AT significantly improved alexithymia, self-compassion, and altered self-capacities compared to therapy alone. These changes address transdiagnostic mental processes that often hinder treatment response.

Study at a glance

Characteristics Randomized, double-blind, placebo-controlled, multi-site Phase 3 clinical trial
Population Patients with severe PTSD
Intervention MDMA-assisted therapy
Duration 2 months after the last experimental session
Topics Psychedelic-assisted therapy
Keywords PTSD Treatment Trauma recovery Mental health intervention Psychiatric treatment Psychological healing
Citations 2
Registration NCT03537014
Key finding MDMA-assisted therapy significantly improved alexithymia, self-compassion, and altered self-capacities compared to psychotherapy alone.

Abstract

In recent years there has been a resurgence of interest in the therapeutic potential of psychedelic substances such as 3,4-methylenedioxymethamphetamine (MDMA). This renaissance of psychedelic studies opens the door for a new paradigm in psychiatric medicine: drug-facilitated psychotherapy. In this study we report the findings of a randomized, double-blind, placebo-controlled, multi-site Phase 3 clinical trial (NCT03537014) to test the effects of MDMA-assisted therapy (MDMA-AT) on patients with severe PTSD. The vast majority (85%) of individuals in this study reported having suffered early childhood trauma, which is strongly associated with deficits in emotional coping skills /altered self-capacities, which have been shown to constitute major obstacles to successful completion of currently available evidence-based treatments. Partcicipants were randomized 1:1 to receive manualized therapy with either MDMA or placebo with three preparatory and nine integrative therapy sessions. Symptoms were measured at baseline and at 2□ months after the last experimental session with the Clinician-Administered PTSD Scale for DSM-5, the Toronto Alexithymia Scale (TAS_20), the Self Compassion Scale (SCS) and the Inventory of Altered Self-Capacities (IASC). MDMA-AT, compared with psychotherapy alone, significantly altered the domains of alexithymia, self-compassion, and altered self-capacities. These findings suggest that MDMA-AT can substantially improve transdiagnostic mental processes associated with poor treatment response.

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