Posttraumatic Growth After MDMA‐Assisted Psychotherapy for Posttraumatic Stress Disorder

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 o...

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Published inJournal of traumatic stress Vol. 33; no. 2; pp. 161 - 170
Main Authors Gorman, Ingmar, Belser, Alexander B., Jerome, Lisa, Hennigan, Colin, Shechet, Ben, Hamilton, Scott, Yazar‐Klosinski, Berra, Emerson, Amy, Feduccia, Allison A.
Format Journal Article
LanguageEnglish
Published United States Wiley Subscription Services, Inc 01.04.2020
John Wiley and Sons Inc
Subjects
Adult
Ecstasy
Female
Humans
Male
Middle Aged
N-Methyl-3,4-methylenedioxyamphetamine - administration & dosage
Non-Randomized Controlled Trials as Topic
Post traumatic stress disorder
Post-traumatic growth
Posttraumatic Growth, Psychological - drug effects
Psychotherapy
Psychotherapy - methods
Severity of Illness Index
Stress Disorders, Post-Traumatic - therapy
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Summary: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.
Bibliography:This work was supported in part by The Multidisciplinary Association for Psychedelic Studies (MAPS), a nonprofit organization. The authors wish to express their gratitude to the individuals who participated in these three studies for committing to the deep and difficult journey of healing; the therapists, Michael Mithoefer, Ann Mithoefer, Marcela Ot'alora, Bruce Poulter, Will Van Derveer, Jim Grigsby, Saj Razvi, Sandra Van Der Veer, Sara Gael Giron, Alison McQueen, Ingrid Pacey, and Hayden Rubensohn, who supported participants throughout their time in the studies; the study coordinators, Sarah Sadler, Peggy Ivers, and Katrina Blommaert, who provided organization and support; Michael Mithoefer, Annie Mithoefer, and Marcela Ot'alora for training therapists; the independent raters, Joy Wymer, Mark Wagner, Carla Clements, Kathryn Kaye, and Zach Walsh; the independent rater intern, Matthew Campeau; the study pharmacists, Kimm Singer, Mel Rauton and Colin Holyk; the clinical research associates, Rebecca Matthews, Charlotte Harrison, and Elizabeth Heimler, who monitored data collection; the adherence raters, who assessed adherence to the manualized therapy; the night attendants, who cared for participants during their overnight stays; and all of the other volunteers, who tirelessly supported the study. The sponsor played a role in the study design, data analysis, and writing of the report (the authors performed all data analyses). Two authors, Ingmar Gorman and Alexander B. Belser, receive consultation fees from Akeso Therapeutics as Coclinical Investigator and Subinvestigator, respectively, for a clinical trial site for the open label multisite study of safety and effects of MDMA‐assisted psychotherapy for treatment of PTSD (ClinicalTrials.gov identifier NCT03282123).
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ISSN:0894-9867
1573-6598
1573-6598
DOI:10.1002/jts.22479