MDMA-assisted psychotherapy for PTSD : Growing evidence for memory effects mediating treatment efficacy

The application of MDMA in conjunction with psychotherapy has in recent years seen a resurgence of clinical, scientific, and public interest in the treatment of posttraumatic stress disorder (PTSD). Clinical trials have shown promising safety and efficacy, but the mechanisms underlying this treatment form remain largely unestablished. This article explores recent preclinical and clinical evidence suggesting that the treatment’s efficacy may be influenced by the mnemonic effects of MDMA. We review data on the effects of MDMA on fear extinction and fear reconsolidation and the utility of these processes for PTSD treatment. We corroborate our findings by incorporating research from cognitive psychology and psychopharmacology and offer recommendations for future research.

Highlights: 

•  The mechanisms mediating the efficacy of MDMA-assisted psychotherapy are unknown.

•  The memory of a traumatic event is influential to PTSD development and maintenance.

•  The memory effects of MDMA may mediate its clinical efficacy for PTSD.

•  MDMA may enhance fear extinction and/or interfere with reconsolidation.

•  Further research on the mnemonic effects of MDMA is encouraged.