MDMA-assisted therapy and current treatment options for chronic, treatment-resistant, moderate or higher severity post-traumatic stress disorder: Systematic literature review
Notice bibliographique
Résumé
BACKGROUND: 3,4-methylenedioxymethamphetamine-assisted therapy (MDMA-AT) is currently being evaluated for treatment of patients with moderate or higher severity post-traumatic stress disorder (PTSD). OBJECTIVE: To provide a comprehensive summary of investigational MDMA-AT and current treatments for PTSD. METHODS: A search was conducted in PubMed and Embase (December 20, 2023). Populations included adults with chronic, treatment-resistant, moderate or higher severity PTSD. Interventions were MDMA-AT and comparators based on PTSD treatment guidelines. The primary outcome of interest was the Clinician-Administered PTSD Scale (CAPS) score. Other outcomes observed were Beck Depression Inventory (BDI), and loss of diagnosis (LOD). Studies observing chronic, moderate or higher severity treatment-resistant PTSD in adults were included. Only randomized controlled trials published in English were considered. The NICE quality appraisal checklist was used to assess risk of bias in included studies. We provided qualitative synthesis of evidence presented in extraction tables. RESULTS: Overall, 77 studies were included. Phase II/III trials consistently reported significantly greater CAPS improvement with MDMA-AT vs. placebo with therapy (PT) after two or three interventional sessions. Durability was observed in a long-term follow-up trial (mean duration, 45.4 months) with a 0.9-point CAPS decrease from post-treatment. FDA-approved and off-label medications used for PTSD treatment did not yield a consistently greater CAPS decrease vs. control arms across trials. Significant CAPS improvement was consistently observed in venlafaxine ER, olanzapine, propranolol (with traumatic memory reactivation), nefazodone, and nabilone placebo-controlled trials. Most psychotherapy trials lacked between-group statistical assessments. Significant CAPS decrease compared to the waitlist was reported for cognitive therapy (CT), cognitive behavioral therapy (CBT), cognitive processing therapy (CPT), prolonged exposure (PE), and group cognitive exposure therapy. CAPS improvement was persistent for CPT and PE in long-term follow up (mean duration 6.2 years). MDMA-AT demonstrated significant improvement in BDI-II score compared to PT (19.7-point vs. 10.8-point decrease, respectively; p = 0.003). The percentage of participants with LOD after two or three active-dose MDMA-AT sessions ranged from 41.7-83.3%. CONCLUSION: This systematic review suggests current treatments for PTSD are associated with heterogeneous evidence and the majority do not demonstrate sustained effects. Results from MDMA-AT showed consistent improvements in CAPS, BDI and LOD.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,005 | 0,001 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».