Post-traumatic stress Disorder (PTSD) is a debilitating mental health condition caused by exposure to highly distressing events that affects millions of people worldwide. The condition is characterized by intrusive memories and feeling constantly “on guard” and emotionally detached, severely impacting someone’s quality of life. Where traditional treatments fall short, psychedelic-assisted therapy is emerging as a promising option for treating PTSD. In this blog, we’ll explain what psychedelic therapy is, the different types, and how these substances can be transformative for those chronically struggling with PTSD.
What Is Psychedelic Therapy?
Psychedelic therapy involves the use of mind-altering substances in combination with psychotherapy. These substances include classical psychedelics such as psilocybin (the active ingredient in magic mushrooms) and non-classical psychedelics like MDMA (also known as ecstasy) and ketamine.
Psychedelics induce an altered state of consciousness, which can aid psychotherapy in three main ways:
- Increasing flexibility of thought, allowing for changed perspectives about one’s life and struggles, and breaking free from negative thought patterns
- Bringing about insight that helps people understand themselves and others better
- Facilitating an emotional release, the process of freeing up suppressed emotions
Why Consider Psychedelics for PTSD?
Current PTSD treatments—such as selective serotonin reuptake inhibitors (SSRIs) and cognitive behavioral therapy (CBT)—can be effective but often fall short. It’s estimated that around 33% of people with PTSD are resistant to treatment, meaning they show no significant change in symptoms from conventional therapy.
Psychotherapy is a key part of treating PTSD. It offers a safe environment for people to work through traumatic memories, shift harmful thought patterns, and learn healthy ways to manage their emotions. However, the process can be long and emotionally intense as it involves revisiting deeply painful experiences. As such, many people with PTSD struggle to stay in treatment and frequently drop out before completing it.
Psychedelic therapy offers a potentially transformative solution. Under the influence of these substances, individuals may find it easier to discuss traumatic memories with a therapist, allowing them to confront the root causes of their symptoms more effectively. Psychedelics also increase flexibility in the brain, helping people more easily shift away from negative thoughts and behaviour.
How Does MDMA-Assisted Therapy Work?
MDMA, until recently, has been mostly associated with the party scene and as a drug of abuse. However, it has been researched as a mental health tool since the 1980s.
MDMA decreases activity in the amygdala, a brain area involved in fear and emotional reactivity. The amygdala is often overactive in PTSD and activates when people are reminded of their trauma, which can hinder therapy. However, by dampening this fear response, MDMA can facilitate people to discuss and process traumatic memories.
MDMA also enhances the release of oxytocin, a chemical messenger that promotes feelings of trust and connection. This helps build a rapport between the patient and therapist, while also addressing symptoms of disconnection.
In a phase 3 clinical trial published in Nature Medicine, 91 participants with severe PTSD were randomly assigned to receive either MDMA or placebo alongside therapy. After three sessions:
- 67% of the MDMA group no longer met the criteria for PTSD.
- 33% achieved full remission.
- In contrast, only 32% of the placebo group no longer met the PTSD criteria, and just 5% achieved remission.
The FDA has granted MDMA a “Breakthrough Therapy” designation for PTSD to speed up research into the drug. While the drug has not yet received approval in the U.S., it is legal for PTSD treatment in Australia.
Psilocybin-Assisted Therapy for PTSD
Psilocybin, the psychoactive compound in magic mushrooms, is also gaining attention for its potential to treat trauma-related disorders. Psilocybin has been shown to promote neuroplasticity, the ability of the brain to form and reorganize connections between nerve cells. This mechanism can help “re-wire” negative patterns of thought and behavior that can develop as a result of traumatic incidents.
Psilocybin also induces what’s known as mystical experiences, characterized by a sense of unity, transcendence, and deep meaning. These types of experiences are correlated with long-lasting positive outcomes on mental health.
While there is less clinical data for psilocybin than for MDMA, early studies are encouraging. One trial published in The Lancet evaluated psilocybin-assisted group therapy in older long-term AIDS survivors, a group with significant trauma exposure. Participants experienced a substantial reduction in PTSD symptoms by the end of the study.
Ketamine-Assisted Therapy for PTSD
Unlike MDMA and psilocybin, ketamine is already legally available in the U.S. and widely used for treatment-resistant depression and PTSD. At Emerge Ketamine, we specialize in this form of therapy.
Ketamine works differently from classic psychedelics, although it has similar outcomes, including:
- Increased neuroplasticity
- Mystical-type experiences (at high doses)
Like MDMA, ketamine can also decrease the reactivity of the amygdala, helping reduce heightened responses to situations.
In one study of 15 veterans with co-morbid depression and PTSD, participants received six ketamine infusions over 12 days. Results showed a significant reduction in PTSD symptoms.
Interestingly, the treatment was effective even without accompanying psychotherapy. This shows that ketamine’s neurobiological effects alone can powerfully reduce mental health symptoms. However, combining ketamine with psychotherapy or other therapeutic approaches can significantly enhance its impact by taking advantage of the brain’s more flexible state after treatment.
Ongoing research is investigating ketamine combined with exposure therapy to treat PTSD. This therapy works by gradually and repeatedly exposing individuals to the thoughts, memories, or situations they fear. By boosting neuroplasticity, ketamine can help people more easily change their response to these triggers.
What Are the Risks and Limitations?
Psychedelic therapy is not without risks, and it’s crucial to undergo treatment under professional supervision. Potential side effects may include:
- MDMA: Elevated heart rate, anxiety, muscle tightness, nausea.
- Psilocybin: Anxiety, paranoia, confusion, nausea, headaches blood pressure, heart rate changes
- Ketamine: Dissociation, dizziness, nausea, pain at injection site, mild increase in heart rate and blood pressure
Psychedelics, especially classical ones like psilocybin, carry psychological risks. While many experiences can be enjoyable and euphoric, others may be distressing, leaving people feeling confused or emotionally worse off than before treatment. While therapeutic settings help reduce these risks, there have been cases where mental health symptoms worsened in psilocybin clinical trials.
Certain conditions also make people unsuitable for psychedelic therapies. For example, MDMA and ketamine can affect the heart, so they’re not recommended for those with certain cardiovascular conditions. Additionally, individuals with a personal or family history of psychosis are generally not eligible for psychedelic therapy.
Where Is Psychedelic Therapy Available?
- Ketamine: The only legally available psychedelic therapy in the U.S., accessible in clinical settings like Emerge Ketamine.
- MDMA: Legal for PTSD treatment in Australia. The treatment was rejected by the FDA last year due to limited evidence. However, this decision may be reconsidered, especially with a new team of federal healthcare officials under Trump.
- Psilocybin: Illegal at the federal level but available through specialized state programs in Colorado and Oregon. A new bill in New Mexico has also legalized psilocybin for medical purposes, but details of the program need to be finalized before services become available.
Apart from ketamine, most psychedelic therapies are currently offered via clinical trials or under tightly regulated programs. However, access is expanding as research progresses and public demand grows.
Psychedelic Therapy for PTSD in Boston
At Emerge Wellness, we are proud to offer advanced ketamine therapy to individuals in the Boston area, available at our clinics in Woburn and Danvers. Our services include:
- Bespoke ketamine infusions tailored to individual needs.
- Expert-led care with a focus on safety and comfort.
- Comprehensive aftercare is designed to help patients integrate their ketamine experiences into long-term healing.
While we do not currently offer fully integrated ketamine-assisted psychotherapy, our treatments can serve as a powerful adjunct to other psychotherapeutic approaches for treating PTSD.
If you or someone you love is living with PTSD and looking for a new way forward, Emerge Ketamine is here to help. Contact us today to learn more about our ketamine therapy services and how they can support your healing journey.
Key Takeaways
- Psychedelic therapy is gaining attention for its ability to treat PTSD. It can help patients confront trauma, shift negative thinking, and release suppressed emotions.
- MDMA helps reduce PTSD by decreasing activity in the amygdala and increasing oxytocin. However, the treatment is only legally available in Australia.
- Psilocybin (Psychedelic Therapy) supports PTSD treatment through mystical experiences and increasing neuroplasticity, but may have the most psychological risks. It can only be accessed legally in Oregon and Colorado.
- Ketamine is a legally available non-classic psychedelic that can significantly support PTSD recovery and may have benefits even without psychotherapy. It has similar mechanisms to psilocybin and MDMA.
- Emerge Wellness is a leading provider of ketamine therapy in Boston.