W26 – MDMA-Assisted Psychotherapy: An Emerging Treatment Paradigm for Post-Traumatic Stress Disorder

W26 – MDMA-Assisted Psychotherapy: An Emerging Treatment Paradigm for Post-Traumatic Stress Disorder

Le vendredi 28 octobre
10:45 – 11:45 (1 hr)
Salle de réunion : Chestnut (Mezzanine)
Emma Hapke*, MD

Rôles CanMEDS :

  1. Expert médical
  2. Érudit
  3. Professionnel

À la conclusion de cette activité, les participants seront en mesure de : 1) Understand the current evidence on the safety and efficacy of MDMA-assisted psychotherapy for post-traumatic stress disorder (PTSD); 2) Describe a course of MDMA-assisted psychotherapy, including screening, preparation, dosing, and integration; and 3) Explore the risks and challenges inherent in this modality of treatment, including boundaries, over-hype in the field, challenges with research design, and equitable access.

Post-traumatic stress disorder (PTSD) is a debilitating psychiatric illness impacting approximately 10% of Canadians, with rates anticipated to increase due to ongoing stress from the pandemic and the impact of climate change. Although current treatment models help some patients, a significant portion of patients remain resistant to current pharmacological and psychotherapeutic approaches. MDMA (3,4-methylenedioxymethamphetamine) is a psychedelic compound showing promising evidence when combined with psychotherapy for treatment-resistant PTSD. This workshop will begin by reviewing current evidence on MDMA-assisted psychotherapy for PTSD, including published Phase 3 trial results. We will highlight safety data, contraindications, and long-term effects. The workshop will then illustrate how a typical course of MDMA-assisted psychotherapy is conducted, including screening, de-prescribing, preparation, dosing sessions, and integration. We will then review the mechanism of action from both a neuroscientific and psychotherapeutic lens. A detailed case presentation will help bring the material to life. The workshop will address the risks with this modality, including over-hype, expectancy, and intensified transference and countertransference, among others. Challenges in the field, including research design and equitable access, will be explored. We will conclude by surveying the current and future regulatory environment and training opportunities. The interactive workshop will feature breakout groups to explore participant perspectives, polls to characterize the audience, and time for questions and answers.

Références :

  1. Mitchell JM, Bogenschutz M, Lilienstein A, et al. MDMA-assisted therapy for severe PTSD: a randomized, double-blind, placebo-controlled phase 3 study. Nat Med 2021;27:1025–33.
  2. Mithoefer MC, Wagner MT, Mithoefer AT, et al. Durability of improvement in post-traumatic stress disorder symptoms and absence of harmful effects or drug dependency after 3,4-methylenedioxymethamphetamine-assisted psychotherapy: a prospective long-term follow-up study. J Psychopharmacol 2013;27(1):28–39.