Efficacy of Psychoactive Drugs for the Treatment of Posttraumatic Stress Disorder: A Systematic Review of MDMA, Ketamine, LSD and Psilocybin

ABSTRACT

The aim of this systematic review was to examine the efficacy of MDMA, ketamine, LSD, and psilocybin for the treatment of posttraumatic stress disorder (PTSD). A search of four databases for English language, peer-reviewed literature published from inception to 18th October 2019 yielded 2,959 records, 34 of which were screened on full-text. Observational studies and RCTs which tested the efficacy of MDMA, ketamine, LSD, or psilocybin for reducing PTSD symptoms in adults, and reported changes to PTSD diagnosis or symptomatology, were included. Nine trials (five ketamine and four MDMA) met inclusion criteria. Trials were rated on a quality and bias checklist and GRADE was used to rank the evidence. The evidence for ketamine as a stand-alone treatment for comorbid PTSD and depression was ranked “very low”, and the evidence for ketamine in combination with psychotherapy as a PTSD treatment was ranked “low”. The evidence for MDMA in combination with psychotherapy as a PTSD treatment was ranked “moderate”.

KEYWORDS:

• Posttraumatic stress disorder
• MDMA
• ketamine
• psilocybin
• LSD

Acknowledgments

The authors would like to thank Dr Shaun Seixas for his help with editing the manuscript. This journal article has been partly funded by the Department of Veterans’ Affairs. The funding source had no role in the study design, collection, analysis or interpretation of the data, writing the manuscript or the decision to submit the paper for publication. The views expressed in this manuscript are not necessarily those of the Department of Veterans’ Affairs.

Disclosure statement

No potential conflict of interest was reported by the authors.

Supplementary material

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Additional information

Funding

This work was supported by the Department of Veterans’ Affairs, Australian Government.