MDMA-assisted therapy reduced PTSD symptoms, but the evidence remains uncertain
An open review of six randomized trials found short-term symptom reductions, while rating the overall evidence as low certainty.
Editorial illustration — not from the study.
The review combines results from six randomized controlled trials of MDMA-assisted therapy for PTSD. Across the studies, treatment was associated with larger reductions in PTSD symptoms than control conditions, as well as higher rates of response and remission.
The researchers have released the review, data and an online dashboard as an open resource that will be updated as new studies appear. All six studies included so far were sponsored by the Multidisciplinary Association for Psychedelic Studies.
What the trials found
The six trials included 286 participants. Compared with control conditions, MDMA-assisted therapy was associated with a greater reduction in PTSD symptoms, with a Hedges’ g of −0.71. Participants receiving MDMA-assisted therapy also had higher response rates, with a risk ratio of 1.35, and higher remission rates, with a risk ratio of 2.25.
The review describes these findings as short-term decreases in PTSD symptoms across the studies available so far. Most studies were judged to have a low risk of bias under Cochrane guidelines, although the researchers noted that those guidelines may not capture important challenges in this field.
Why the review matters
PTSD treatments involving MDMA are being studied in a rapidly changing research area, making it difficult to keep findings current. This living review and its open database provide a way for researchers and others to follow the evidence as new trials are added.
The findings indicate short-term benefits across the trials reviewed, but the low certainty rating means the results should not be treated as settled evidence. The review makes both the current findings and their limitations easier to examine.
Evidence and caveats
This is a systematic review and meta-analysis of six randomized controlled trials, rather than a new clinical trial. The studies included 286 participants, and all six were sponsored by the Multidisciplinary Association for Psychedelic Studies.
The researchers assigned the overall evidence a low certainty rating using the GRADE approach. They also identified limitations that may be especially relevant to MDMA studies, including expectancy effects, functional unblinding, possible issues with study conduct and safety. The review is a living resource and may change as further evidence emerges.
People have fished for tuna for about 44,000 years and billfish for about 10,000 years, according to a global review of archaeological evidence. But sustained, intensive fishing in offshore and oceanic waters appears to have developed mainly during the past 200 years.
People considering whether to leave flood-prone coastal communities weigh disastrous flooding and rising costs alongside crime, healthcare and proximity to family and friends. In a survey of 182 respondents, most said they would not relocate, while others said they would move immediately or in the future.
A study of eight managers found that they preferred human coaches for reflective questioning, even though they welcomed that approach from a person. When the same coaching protocol came from an AI system, they wanted it to provide answers instead.
