PMID- 31437480
OWN - NLM
STAT- MEDLINE
DCOM- 20210104
LR  - 20210104
IS  - 1878-4216 (Electronic)
IS  - 0278-5846 (Linking)
VI  - 96
DP  - 2020 Jan 10
TI  - Efficacy of 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy for 
      posttraumatic stress disorder: A systematic review and meta-analysis.
PG  - 109735
LID - S0278-5846(19)30148-4 [pii]
LID - 10.1016/j.pnpbp.2019.109735 [doi]
AB  - BACKGROUND: Posttraumatic stress disorder (PTSD) is a common psychiatric 
      condition that can develop following a traumatic experience. PTSD is associated 
      with significant disability, a large economic burden, and despite the range of 
      therapies to treat PTSD, response to antidepressants is limited. A growing body 
      of clinical research suggests the efficacy of 3,4-methylenedioxymethamphetamine 
      (MDMA)-assisted psychotherapy in individuals with treatment-refractory PTSD. AIM: 
      To assess the effectiveness and safety of MDMA-assisted psychotherapy for 
      reducing symptoms of PTSD, a systematic review and meta-analysis was undertaken. 
      METHODS: Six online databases were searched from inception to December 2018. 
      Reference lists of relevant articles were manually searched as well as electronic 
      sources of ongoing trials and conference proceedings. Researchers active in the 
      subject were also contacted. Eligible studies included randomized and 
      quasi-randomized clinical trials using MDMA-assisted psychotherapy for PTSD in 
      comparison with other medications, placebo or no medication (supportive care). We 
      used standard methodological procedures expected by the Cochrane Collaboration. 
      Two authors assessed studies for inclusion and extracted data. Using 
      random-effects meta-analysis with Cochrane's Review Manager 5.3, we obtained 
      standardized mean differences [SMD] and rate ratios [RR] for reduction in PTSD 
      symptomatology. RESULTS: A total of 5 trials met inclusion criteria, totaling 106 
      participants (average age: 35-40 years, 70% female). Studies were rated as 
      moderate in quality. MDMA-assisted psychotherapy demonstrated a high rate of 
      clinical response (RR = 3.47, 95% CI: 1.70, 7.06), remission (RR = 2.63, 95% CI: 
      1.37, 5.02), with a large effect size at reducing the symptoms of PTSD (SMD = 
      1.30, 95% CI: 0.66, 1.94). Available evidence indicates that MDMA was 
      well-tolerated, with few serious adverse events reported across studies. 
      CONCLUSIONS: MDMA-assisted psychotherapy appears to be a potentially safe, 
      effective, and durable treatment for individuals with chronic, 
      treatment-refractory PTSD. However, future studies involving larger samples and 
      longer durations of treatment and follow-up are warranted-and underway.
CI  - Copyright (c) 2019 Elsevier Inc. All rights reserved.
FAU - Bahji, Anees
AU  - Bahji A
AD  - Department of Psychiatry, Queen's University, Kingston, Ontario, Canada; 
      Department of Public Health Sciences, Queen's University, Kingston, Ontario, 
      Canada. Electronic address: 0ab104@queensu.ca.
FAU - Forsyth, Ashleigh
AU  - Forsyth A
AD  - Department of Psychiatry, Queen's University, Kingston, Ontario, Canada; 
      Providence Care Hospital, Kingston, Ontario, Canada.
FAU - Groll, Dianne
AU  - Groll D
AD  - Department of Psychiatry, Queen's University, Kingston, Ontario, Canada.
FAU - Hawken, Emily R
AU  - Hawken ER
AD  - Department of Psychiatry, Queen's University, Kingston, Ontario, Canada; 
      Providence Care Hospital, Kingston, Ontario, Canada.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20190819
PL  - England
TA  - Prog Neuropsychopharmacol Biol Psychiatry
JT  - Progress in neuro-psychopharmacology & biological psychiatry
JID - 8211617
RN  - 0 (Adrenergic Uptake Inhibitors)
RN  - 0 (Antidepressive Agents)
RN  - KE1SEN21RM (N-Methyl-3,4-methylenedioxyamphetamine)
SB  - IM
MH  - Adrenergic Uptake Inhibitors/*administration & dosage
MH  - Antidepressive Agents/administration & dosage
MH  - Cognitive Behavioral Therapy/methods
MH  - Combined Modality Therapy/methods
MH  - Humans
MH  - N-Methyl-3,4-methylenedioxyamphetamine/*administration & dosage
MH  - Psychotherapy/*methods
MH  - Randomized Controlled Trials as Topic/methods
MH  - Stress Disorders, Post-Traumatic/diagnosis/*psychology/*therapy
MH  - Treatment Outcome
EDAT- 2019/08/23 06:00
MHDA- 2021/01/05 06:00
CRDT- 2019/08/23 06:00
PHST- 2019/02/19 00:00 [received]
PHST- 2019/06/27 00:00 [revised]
PHST- 2019/08/10 00:00 [accepted]
PHST- 2019/08/23 06:00 [pubmed]
PHST- 2021/01/05 06:00 [medline]
PHST- 2019/08/23 06:00 [entrez]
AID - S0278-5846(19)30148-4 [pii]
AID - 10.1016/j.pnpbp.2019.109735 [doi]
PST - ppublish
SO  - Prog Neuropsychopharmacol Biol Psychiatry. 2020 Jan 10;96:109735. doi: 
      10.1016/j.pnpbp.2019.109735. Epub 2019 Aug 19.