MDMA-Assisted Psychotherapy for Borderline Personality Disorder

Focus (Am Psychiatr Publ). 2022 Oct;20(4):358-367. doi: 10.1176/appi.focus.20220056. Epub 2022 Oct 25.

Abstract

Borderline personality disorder is a complex psychiatric disorder with limited treatment options that are associated with large heterogeneity in treatment response and high rates of dropout. New or complementary treatments for borderline personality disorder are needed that may be able to bolster treatment outcomes. In this review, the authors comment on the plausibility for research on 3,4-methylenedioxymethamphetamine (MDMA) used in conjunction with psychotherapy for borderline personality disorder (i.e., MDMA-assisted psychotherapy [MDMA-AP]). On the basis of the promise of MDMA-AP in treating disorders overlapping with borderline personality disorder (e.g., posttraumatic stress disorder), the authors speculate on initial treatment targets and hypothesized mechanisms of change that are grounded in prior literature and theory. Initial considerations for designing MDMA-AP clinical trials to investigate the safety, feasibility, and preliminary effects of MDMA-AP for borderline personality disorder are also presented.

Keywords: Borderline personality disorder; Drug treatment/psychopharmacology; MDMA-assisted psychotherapy; clinical trials; psychedelic-assisted psychotherapy.

Publication types

  • Review