Ecstasy and psychotherapy combined for PTSD

Magic mushrooms and ecstasy show the most promise when it comes to helping people with post-traumatic stress disorder, a new review has suggested.

In what is the first review the use of novel treatments alongside already accepted psychotherapy and psychological counselling, the authors say psychedelic medications, such as MDMA (ecstasy) and psilocybin (magic mushrooms) show the greatest promise for treatment, particularly in cases of mass trauma.

The findings of the review, led by Dr Xenia Gonda, of Semmelweis University, Budapest, Hungary, are published min *European Neuropsychopharmacology*.

She said psychotherapy is still the first choice for PTSD treatment and there is no effective established pharmacological treatment specifically for PTSD.

“However, psychotherapies may have a limited availability, are very lengthy and expensive. In addition, there are several different psychotherapeutic methods and only very few evidence-based interventions,” she said.

“We are beginning to see new approaches to PTSD treatment, which combines psychotherapy and medication. Both the psychotherapy and the drug treatment have an effect independently, but they often work together synergistically.

“There are several such drugs in development, but our review shows that newer psychedelic drugs seem to be the stand-out candidates in this treatment.

“It’s important to say that it’s not the psychedelic nature of the drugs that seem to have the beneficial effect in PTSD, these drugs seem to work, at least in part, by enhancing the actions of psychotherapy at a neurological level”.

The review found that MDMA-assisted psychotherapy showed the greatest promise so far, with four trials showing significantly superior outcomes to those experience by patients receiving only psychotherapy.

Trials on the use of psilocybin, found naturally in certain mushrooms, also show promise, but the researchers say additional data are needed to validate the therapeutic benefits.

Gonda X, Dome P, Erdelyi-Hamza B et al. Invisible wounds: Suturing the gap between the neurobiology, conventional and emerging therapies for posttraumatic stress disorder. *European Neuropsychopharmacology*. August 2022

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