Treating posttraumatic stress disorder and alcohol use disorder comorbidity: Current pharmacological therapies and the future of MDMA-integrated psychotherapy

J Psychopharmacol. 2023 Dec;37(12):1182-1189. doi: 10.1177/02698811231200880. Epub 2023 Nov 27.

Abstract

Posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) frequently co-occur in patients who have experienced trauma. This comorbidity leads to a vicious cycle where PTSD symptoms beget heavy drinking and vice versa. There are no FDA-approved medications to treat PTSD-AUD; therefore, individuals suffering from this comorbidity are treated with medication approved to treat the disorders separately or with off-label pharmacological interventions. However, these medications are limited in their efficacy for treating PTSD-AUD comorbidity. Emerging research on the nonclassical psychedelic drug 3,4-methylenedioxymethamphetamine (MDMA) suggests that it may be an effective drug used in conjunction with psychotherapy. The following reviews the current research for clinical pharmacotherapies, as well as MDMA-integrative psychotherapy as they pertain to PTSD and AUD in isolation and co-occurrence. Future directions for the role of psychedelic-integrative therapy for the treatment of this comorbidity are discussed.

Keywords: Alcohol use disorder; comorbidity; posttraumatic stress disorder; psychedelics.

Publication types

  • Review
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Alcoholism* / drug therapy
  • Alcoholism* / epidemiology
  • Comorbidity
  • Hallucinogens* / therapeutic use
  • Humans
  • N-Methyl-3,4-methylenedioxyamphetamine* / therapeutic use
  • Psychotherapy
  • Stress Disorders, Post-Traumatic* / diagnosis
  • Stress Disorders, Post-Traumatic* / drug therapy

Substances

  • N-Methyl-3,4-methylenedioxyamphetamine
  • Hallucinogens