Current clinical practice guidelines for the treatment of adult post-traumatic stress disorder (PTSD) from the American Psychological Association strongly recommend that clinicians offer cognitive behavioral therapy, brief eclectic psychotherapy, narrative exposure therapy, eye movement desensitization and reprocessing therapy, or prolonged exposure therapy compared to no intervention. For adult patients with PTSD, the panel also strongly recommends use of fluoxetine, paroxetine, sertraline, or venlafaxine compared to no intervention. The panel concludes that there is insufficient evidence to recommend for or against the use of risperidone or topiramate for patients with PTSD. [1]
A 2020 review assessing 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy for patients with treatment-resistant PTSD found that MDMA-assisted therapy may be effective for patients who have suffered psychological trauma and have not been able to resolve their problems through existing treatments. However, many of the studies reviewed were small-scale. Researchers found that there was much misinterpretation regarding the available literature leading to controversy, misrepresentation by the media, and dangerous mis-informed decision-making by patients. Overall, the researchers concluded that MDMA-assisted psychotherapy is a promising approach. However, better, more defined studies need to take place in order to study the effectiveness, safety, and long-term effects of MDMA-assisted therapy. [2]
A 2017 review assessing MDMA for PTSD-treatment (during phase-2 studies) stated that MDMA could affect PTSD symptoms in the following ways: reduces depression and anxiety, stimulates alterations in the perceptions of meaning, raises levels of arousal, increases relaxation, improves fear extinction learning, increases emotional attachment and feelings of trust and empathy, produces reduced social exclusion phenomena, leads to improved detection of happy faces and reduced detection of negative facial expressions, and leads to reduced subjective fear response on recall of negative memories. [3]
Another 2020 review assessing the role of psychedelics and psychotherapy found that there is evidence supporting the efficacy of MDMA for PTSD, and psilocybin for depression and cancer-related anxiety. There is preliminary research for the use of lysergic acid diethylamide (LSD) and ayahuasca in the treatment of psychiatric disorders. However, the researchers concluded that there is not enough evidence for any psychedelic compound to be used for routine clinical use in psychiatric disorders at this time, and more trials need to be conducted to better study efficacy, safety, and long-term effects. [4]