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. 2021 Jan 15;12(1):1853379.
doi: 10.1080/20008198.2020.1853379.

Pharmacological-assisted Psychotherapy for Post-Traumatic Stress Disorder: a systematic review and meta-analysis

Mathew D Hoskins  1 , Robert Sinnerton  1 , Anna Nakamura  1 , Jack F G Underwood  1 , Alan Slater  1 , Catrin Lewis  1 , Neil P Roberts  1 , Jonathan I Bisson  1 , Matthew Lee  1 , Liam Clarke  1
Affiliations

Pharmacological-assisted Psychotherapy for Post-Traumatic Stress Disorder: a systematic review and meta-analysis

Mathew D Hoskins et al. Eur J Psychotraumatol. .

Abstract
in English, Spanish, Chinese

Background: Pharmacological-assisted psychotherapies, using conventional and novel drug agents, are increasingly being used both in clinical and experimental research settings, respectively. Objective: To determine the efficacy of conventional and novel pharmacological-assisted psychotherapies in reducing PTSD symptom severity. Method: A systematic review and meta-analysis of randomised-controlled trials were undertaken; 21 studies were included. Results: MDMA-assisted therapy was found to statistically superior to active and inactive placebo-assisted therapy in reduction of PTSD symptoms (standardised mean difference -1.09, 95% CI -1.60 to -0.58). There was no evidence of superiority over placebo for any other intervention. Conclusions: MDMA-assisted therapy demonstrated an impressive effect size; however, it is difficult to have confidence at this stage in this intervention due to the small numbers of participants included, and more research in this area is needed. There was no evidence to support the efficacy of any other drug-assisted interventions.

Antecedentes: Las psicoterapias asistidas farmacológicamente, que utilizan fármacos convencionales y nuevos, están siendo cada vez más utilizadas tanto en contextos clínicos como de investigación experimental, respectivamente.Objetivos: Determinar la eficacia de las psicoterapias asistidas con fármacos convencionales y nuevos para reducir la severidad de los síntomas TEPT.Método: Se llevó a cabo una revisión sistemática y un metanálisis de estudios controlados aleatorizados; se incluyeron 21 estudios.Resultados: Se encontró que la terapia asistida por MDMA era estadísticamente superior a terapia asistida por placebo activo e inactivo en la reducción de los síntomas de TEPT (diferencia de medias estandarizada −1.09, IC del 95%: −1.60 a −0.58). No hubo evidencia de superioridad sobre placebo para ninguna otra intervención.Conclusiones: La terapia asistida por MDMA demostró un tamaño de efecto impresionante; sin embargo es difícil tener confianza en esta etapa en esta intervención debido al pequeño número de participantes incluidos, y se necesita más investigación en esta área. No hubo evidencia para apoyar la eficacia de ninguna otra intervención asistida por fármacos.

背景: 使用传统药物和新型药物的药物辅助心理治疗分别越来越多地用于临床和实验研究环境中。目的: 确定传统和新型药物辅助心理治疗在降低PTSD症状严重程度方面的效能。方法: 对随机对照试验进行了系统综述和元分析。纳入了21项研究。结果: 发现在降低PTSD症状方面, MDMA辅助治疗在统计学上优于阳性对照和安慰剂辅助治疗 (标准平均差-1.09, 95%CI −1.60至-0.58) 。没有证据表明任何其他干预措施优于安慰剂的证据。结论:MDMA辅助治疗展现出了令人印象深刻的效应量。但是, 由于参与人数少, 目前对这种干预措施很难有信心, 因此需要这一领域的更多研究。没有证据支持任何其他药物辅助干预措施的效能。.

Keywords: D-cycloserine; MDMA; PTSD; SNRI; SSRI; drug-assisted therapy; pharmacological therapy.

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Conflict of interest statement

Dr Hoskins has received MDMA-assisted psychotherapy training and travel expenses from MAPS. Professor Bisson and Dr Hoskins are co-applicants on a MAPS-sponsored Phase 2 clinical trial of MDMA-assisted psychotherapy taking place with Cardiff University and Cardiff and Vale University Health Board (NHS).

Figures

Figure 1.
Figure 1.
Flow diagram of included studies
Figure 2.
Figure 2.
SSRI-assisted therapy versus placebo-assisted therapy
Figure 3.
Figure 3.
DCS-assisted therapy versus placebo-assisted therapy
Figure 4.
Figure 4.
MDMA-assisted therapy versus placebo/active placebo-assisted therapy
Figure 5.
Figure 5.
SSRI plus PE versus SSRI
See this image and copyright information in PMC

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