AUTHOR=Christie Devon , Yazar-Klosinski Berra , Nosova Ekaterina , Kryskow Pam , Siu Will , Lessor Danielle , Argento Elena 

TITLE=MDMA-assisted therapy is associated with a reduction in chronic pain among people with post-traumatic stress disorder

JOURNAL=Frontiers in Psychiatry

VOLUME=13

YEAR=2022

URL=https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2022.939302

DOI=10.3389/fpsyt.2022.939302

ISSN=1664-0640

ABSTRACT=<sec><title>Introduction</title><p>Increasing evidence demonstrates 3,4-methylenedioxymethamphetamine (MDMA)-assisted therapy (MDMA-AT) may be a safe and effective treatment for post-traumatic stress disorder (PTSD). There is growing interest in MDMA-AT to address a range of other health challenges. Chronic pain and PTSD are frequently comorbid, reciprocally interdependent conditions, though the possible role of MDMA-AT in treating chronic pain remains under-investigated. The present analysis examined the impact of manualized MDMA-AT on chronic pain severity among participants with PTSD who were enrolled in a Phase 2 clinical trial investigating MDMA-AT for PTSD (NCT03282123).</p></sec><sec><title>Materials and methods</title><p>Exploratory data from a subset of participants who completed chronic pain measures (<italic>n</italic> = 32) were drawn from a Phase 2 open-label study sponsored by the Multidisciplinary Association for Psychedelic Studies (MAPS). Multivariable analysis of variance (ANOVA) was utilized to compare pre- vs. post-treatment Chronic Pain Grade Scale (CPGS) values, adjusting for demographics (age, sex, and ethnicity). K-means clustering was then used to group the sample into three clusters to denote high (<italic>n</italic> = 9), medium (<italic>n</italic> = 11), and low (<italic>n</italic> = 12) baseline pain severity, and the same analysis was repeated for each cluster.</p></sec><sec><title>Results</title><p>Among the 32 participants included in this analysis, 59% (<italic>n</italic> = 19) were women, 72% (<italic>n</italic> = 23) were white, and median age was 38 years [interquartile range (IQR) = 31–47]. Overall, 84% (<italic>n</italic> = 27) reported having pain, and 75% (<italic>n</italic> = 24) reported disability associated with their pain. Significant reductions in CPGS subscales for <italic>pain intensity</italic> and <italic>disability score</italic>, and overall CPGS <italic>severity grade</italic> were observed among participants in the highest pain cluster (<italic>n</italic> = 9, <italic>p</italic> &lt; 0.05), and for <italic>pain intensity</italic> in the medium pain cluster (<italic>n</italic> = 11, <italic>p</italic> &lt; 0.05) post- vs. pre-treatment.</p></sec><sec><title>Discussion</title><p>Findings demonstrate a high prevalence of chronic pain in this sample of people with severe PTSD and that chronic pain scores among medium and high pain subgroups were significantly lower following MDMA-AT. While these data are preliminary, when considered alongside the frequency of comorbid chronic pain and PTSD and promising efficacy of MDMA-AT for treating PTSD, these findings encourage further research exploring the role of MDMA-AT for chronic pain.</p></sec>