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MDMA-Assisted Therapy Reduces Chronic Pain in PTSD Patients
In a small study of patients with severe post-traumatic stress disorder (PTSD), MDMA-assisted therapy was found to significantly reduce chronic pain scores among medium- and high-pain subgroups.
Findings from the study were published in Frontiers in Psychiatry.
The study used exploratory data from a subset of participants in a Phase 2 open-label clinical trial investigating MDMA-assisted therapy for PTSD that was sponsored by the Multidisciplinary Association for Psychedelic Studies (MAPS).
“Chronic pain is an international public health emergency for which new treatments are desperately needed,” the study’s authors wrote. “While chronic pain is frequently comorbid with PTSD, few studies have examined treatments designed to effectively address both conditions concurrently, yet when outcomes are assessed related to psychological interventions for both disorders in individual studies, moderate effects for PTSD and small effects for pain emerge, suggesting transdiagnostic effects.”
The trial included 33 participants overall, 32 of whom completed assessments of chronic pain at the beginning and end of the study, using a tool known as the Chronic Pain Grade Scale (CPGS). Among the subset of participants who completed the assessments, 52% were women, 72% were White, and the median age was 38 years. Overall, 84% of participants reported having pain, with 75% reporting disability associated with their pain.
Trial participants engaged in a series of therapy sessions delivered by 2 clinicians. MDMA was administered on 3 occasions, with each session lasting 8 hours. Sessions were spaced 3 to 5 weeks apart and were preceded and/or followed by 3 non-drug 90-minute sessions to prepare for and/or facilitate psychotherapeutic integration of each session. In the initial session, all participants received an initial dose of 80 mg MDMA HCl, followed by a 40 mg dose administered 1 ½ to 2 ½ hours later. In the ensuing sessions, dosages were increased to 120 mg and 60 mg.
The CPGS was administered twice—once prior to participants’ first MDMA session, and once at study termination, which occurred 10 to 14 weeks after the final MDMA administration was completed. Researchers found that among those in the highest pain cluster, CPGS values for pain intensity, disability score, and severity grade were significantly reduced post-intervention vs. baseline. Among those in the medium pain cluster, a significant reduction in pain intensity was observed.
“These findings demonstrate a high prevalence of pain in this sample of participants with severe PTSD, and that pain intensity, disability, and a composite pain severity index grade among those with the highest pain were significantly lower following MDMA-assisted therapy,” the researchers wrote. “While these data are limited and primarily hypothesis generating, they suggest that MDMA-AT may be associated with reductions in pain and pain-related disability among individuals with PTSD.”
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