O potencial do MDMA como ferramenta no tratamento do transtorno de estresse pós-traumático: uma revisão integrativa

Abstract

Post-Traumatic Stress Disorder (PTSD) is an anxiety disorder that has very debilitating symptoms and can affect any previously healthy individual after exposure to one or more traumatic events. The disorder, due to the chronicity and severity of the symptoms, means that patients may have a substantial reduction in their quality of life, as well as limitations in the work, social and family context. The therapeutic strategy currently adopted has low rates of efficacy, high dropout rates and high rates of symptom recurrence. In this context, recent studies have been carried out to assess the effectiveness of alternative treatments for PTSD. 3,4- Methylenedioxymethamphetamine (MDMA)-assisted psychotherapy is the most researched treatment in recent decades and has the most promising results. This integrative review was carried out with the aim of synthesizing and discussing the results of the most current and relevant studies on the potential of treatment using MDMA in patients with post-traumatic stress disorder. This study is an integrative review based on the recommendations of the PRISMA protocol and the Cochrane Handbook for Systematic Reviews of Intervention. The search was carried out on the PubMed /MEDLINE, SciELO and LILACS platforms with the following descriptors: MDMA, PTSD and Treatment. Eligible for inclusion were: primary clinical studies, systematic reviews with meta-analysis and analytical modeling; in English, Spanish or Portuguese, published between 2010 and 2022, whose population was: individuals diagnosed with PTSD; as exposure: psychotherapy associated with MDMA and in which the outcome was linked to the change in the patients' symptoms in the short and long term. Based on the inclusion and exclusion criteria, 10 studies were selected to compose the review. In addition, selected studies were assessed for risk of bias. The present study shows that MDMA-assisted psychotherapy has much better results in the treatment of patients with PTSD compared to psychotherapy alone and psychotherapy associated with selective serotonin reuptake inhibitors (SSRIs). It also shows that MDMA therapy has a superior ability to reduce PTSD symptoms in the short and long term, especially in patients refractory to conventional treatments. In addition, it also highlights points on which scientific research on the subject could focus, with the objective of producing data that provide more confidence to psychiatrists in the management of patients with different comorbidities and in use of other drugs. Finally, it emphasizes that no significant risk of serious adverse events was reported during the trials and the treatment showed satisfactory levels of safety in controlled clinical settings.