PMID- 33345689
OWN - NLM
STAT- MEDLINE
DCOM- 20220119
LR  - 20220123
IS  - 1461-7285 (Electronic)
IS  - 0269-8811 (Linking)
VI  - 35
IP  - 5
DP  - 2021 May
TI  - A comparison of MDMA-assisted psychotherapy to non-assisted psychotherapy in 
      treatment-resistant PTSD: A systematic review and meta-analysis.
PG  - 501-511
LID - 10.1177/0269881120965915 [doi]
AB  - RATIONALE: Novel, evidence-based treatments are required for treatment-resistant 
      post-traumatic stress disorder (PTSD). 3,4-Methylenedioxymethamphetamine (MDMA) 
      has beneficially augmented psychotherapy in several small clinical trials. 
      OBJECTIVE: To review the use of MDMA-assisted psychotherapy in 
      treatment-resistant PTSD. METHODS: Systematic searches of four databases were 
      conducted from inception to February 2020. A meta-analysis was performed on 
      trials which were double-blinded, randomised, and compared MDMA-assisted 
      psychotherapy to psychotherapy and placebo. The primary outcomes were the 
      differences in Clinician Administered PTSD Scale (CAPS-IV) score and Beck's 
      Depression Inventory (BDI). Secondary outcome measures included neurocognitive 
      and physical adverse effects, at the time, and within 7 days of intervention. 
      RESULTS: Four randomised controlled trials (RCTs) met inclusion criteria. When 
      compared to active placebo, intervention groups taking 75 mg (MD -46.90; 95% 
      (confidence intervals) CI -58.78, -35.02), 125 mg (MD -20.98; 95% CI -34.35, 
      -7.61) but not 100 mg (MD -12.90; 95% CI -36.09, 10.29) of MDMA with 
      psychotherapy, had significant decreases in CAPS-IV scores, as did the inactive 
      placebo arm (MD -33.20; 95% CI -40.53, -25.87). A significant decrease in BDI 
      when compared to active placebo (MD -10.80; 95% CI -20.39, -1.21) was only 
      observed at 75 mg. Compared to placebo, participants reported significantly more 
      episodes of low mood, nausea and jaw-clenching during sessions and lack of 
      appetite after 7 days. CONCLUSION: These results demonstrate potential 
      therapeutic benefit with minimal physical and neurocognitive risk for the use of 
      MDMA-assisted psychotherapy in TR-PTSD, despite little effect on Beck's 
      Depression Inventory. Better powered RCTs are required to investigate further. 
      INTERNATIONAL PROSPECTIVE REGISTER OF SYSTEMATIC REVIEWS: CRD42019109132 
      available online at www.crd.york.ac.uk/prospero.
FAU - Illingworth, Benjamin Jg
AU  - Illingworth BJ
AUID- ORCID: 0000-0002-7990-2634
AD  - Peterborough City Hospital, North West Anglia NHS Foundation Trust, Peterborough, 
      UK.
FAU - Lewis, Declan J
AU  - Lewis DJ
AD  - University College London Medical School, London, UK.
FAU - Lambarth, Andrew T
AU  - Lambarth AT
AD  - North Middlesex Hospital, North Middlesex University Hospital NHS Trust, London, 
      UK.
FAU - Stocking, Kate
AU  - Stocking K
AD  - Centre for Biostatistics, The University of Manchester, Manchester, UK.
FAU - Duffy, James Mn
AU  - Duffy JM
AD  - Institute for Women's Health, University College London, London, UK.
AD  - The Fetal Medicine Research Institute, King's College Hospital NHS Foundation 
      Trust, London, UK.
FAU - Jelen, Luke A
AU  - Jelen LA
AUID- ORCID: 0000-0001-6398-5239
AD  - Centre for Affective Disorders, King's College London, London, UK.
FAU - Rucker, James J
AU  - Rucker JJ
AUID- ORCID: 0000-0003-4647-8088
AD  - Centre for Affective Disorders, King's College London, London, UK.
LA  - eng
GR  - CS-2017-17-007/DH_/Department of Health/United Kingdom
PT  - Comparative Study
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Systematic Review
DEP - 20201220
PL  - United States
TA  - J Psychopharmacol
JT  - Journal of psychopharmacology (Oxford, England)
JID - 8907828
RN  - 0 (Hallucinogens)
RN  - KE1SEN21RM (N-Methyl-3,4-methylenedioxyamphetamine)
SB  - IM
MH  - Combined Modality Therapy
MH  - Hallucinogens/administration & dosage/adverse effects
MH  - Humans
MH  - N-Methyl-3,4-methylenedioxyamphetamine/*administration & dosage/adverse effects
MH  - Psychiatric Status Rating Scales
MH  - Psychotherapy/*methods
MH  - Randomized Controlled Trials as Topic
MH  - Stress Disorders, Post-Traumatic/physiopathology/*therapy
MH  - Treatment Outcome
OTO - NOTNLM
OT  - 3,4-Methylenedioxymethamphetamine
OT  - MDMA
OT  - PTSD
OT  - novel therapies
OT  - post-traumatic stress disorder
OT  - psychotherapy
OT  - treatment-resistance
EDAT- 2020/12/22 06:00
MHDA- 2022/01/20 06:00
CRDT- 2020/12/21 08:43
PHST- 2020/12/22 06:00 [pubmed]
PHST- 2022/01/20 06:00 [medline]
PHST- 2020/12/21 08:43 [entrez]
AID - 10.1177/0269881120965915 [doi]
PST - ppublish
SO  - J Psychopharmacol. 2021 May;35(5):501-511. doi: 10.1177/0269881120965915. Epub 
      2020 Dec 20.