MDMA-assisted therapy significantly reduces eating disorder symptoms in a randomized placebo-controlled trial of adults with severe PTSD

J Psychiatr Res. 2022 May:149:128-135. doi: 10.1016/j.jpsychires.2022.03.008. Epub 2022 Mar 5.


Introduction: Eating disorders (EDs) and posttraumatic stress disorder (PTSD) are highly comorbid, yet there are no proven integrative treatment modalities for ED-PTSD. In clinical trials, MDMA-assisted therapy (MDMA-AT) has shown marked success in the treatment of PTSD and may be promising for ED-PTSD.

Methods: Ninety individuals with severe PTSD received treatment in a double-blind, placebo-controlled pivotal trial of MDMA-AT. In addition to the primary (Clinician-Administered PTSD Scale) and secondary (Sheehan Disability Scale) outcome measures, the Eating Attitudes Test 26 (EAT-26) was administered for pre-specified exploratory purposes at baseline and at study termination.

Results: The study sample consisted of 58 females (placebo = 31, MDMA = 27) and 31 males (placebo = 12, MDMA = 19) (n = 89). Seven participants discontinued prior to study termination. At baseline, 13 (15%) of the 89 individuals with PTSD had total EAT-26 scores in the clinical range (≥20), and 28 (31.5%) had total EAT-26 scores in the high-risk range (≥11) despite the absence of active purging or low weight. In completers (n = 82), there was a significant reduction in total EAT-26 scores in the total group of PTSD participants following MDMA-AT versus placebo (p = .03). There were also significant reductions in total EAT-26 scores in women with high EAT-26 scores ≥11 and ≥ 20 following MDMA-AT versus placebo (p = .0012 and p = .0478, respectively).

Conclusions: ED psychopathology is common in individuals with PTSD even in the absence of EDs with active purging and low weight. MDMA-AT significantly reduced ED symptoms compared to therapy with placebo among participants with severe PTSD. MDMA-AT for ED-PTSD appears promising and requires further study.

Keywords: EAT-26; Eating disorders; MDMA-Assisted therapy; PTSD; Treatment.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Combined Modality Therapy
  • Double-Blind Method
  • Feeding and Eating Disorders* / drug therapy
  • Feeding and Eating Disorders* / etiology
  • Female
  • Humans
  • Male
  • N-Methyl-3,4-methylenedioxyamphetamine*
  • Psychotherapy
  • Stress Disorders, Post-Traumatic* / complications
  • Stress Disorders, Post-Traumatic* / diagnosis
  • Stress Disorders, Post-Traumatic* / drug therapy
  • Treatment Outcome


  • N-Methyl-3,4-methylenedioxyamphetamine