{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T18:51:17Z","timestamp":1780426277772,"version":"3.54.1"},"reference-count":80,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T00:00:00Z","timestamp":1773273600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T00:00:00Z","timestamp":1773273600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Traumatic Stress"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>There is growing interest in novel approaches to treating posttraumatic stress disorder (PTSD), including the use of psychedelic substances combined with psychotherapy, often referred to as psychedelic\u2010assisted therapy, to better meet the needs of patients who do not prefer or respond to traditional evidence\u2010based treatments. Among these treatments, 3,4\u2010methylenedioxymethamphetamine (MDMA)\u2013assisted psychotherapy (MDMA\u2010AT) has shown promising outcomes in recent randomized controlled trials, with high response and remission rates. However, the U.S. Food and Drug Administration declined to approve MDMA\u2010AT for marketable use in August 2024 due to concerns about insufficient evidence. This paper reviews the current state of the scientific literature on MDMA\u2010AT for PTSD, including putative mechanisms of action; key strengths and limitations of methodologies used to date; gaps in the evidence; and clinical, ethical, and regulatory considerations. Key limitations to be addressed in future studies include challenges with blinding, a lack of active comparator conditions, a lack of head\u2010to\u2010head comparisons of different models, inadequate safety monitoring, and limited sample generalizability. We describe emerging research that integrates MDMA with established trauma\u2010focused therapies, such as prolonged exposure therapy and cognitive processing therapy, to leverage MDMA's effects on known cognitive behavioral mechanisms of action and support future implementation. Future research directions for advancing knowledge and consideration for the dissemination of MDMA\u2010AT are discussed.<\/jats:p>","DOI":"10.1002\/jts.70060","type":"journal-article","created":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T03:38:53Z","timestamp":1773373133000},"page":"173-187","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["State of the Science: MDMA\u2010assisted psychotherapy for the treatment of posttraumatic stress disorder"],"prefix":"10.1002","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2032-6553","authenticated-orcid":false,"given":"Leslie A.","family":"Morland","sequence":"first","affiliation":[{"name":"Veterans Affairs San Diego Healthcare System  San Diego California USA"},{"name":"Department of Psychiatry University of California San Diego  La Jolla California USA"},{"name":"Women's Health Sciences Division, Department of Veterans Affairs National Center for PTSD Boston  Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara O.","family":"Rothbaum","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Emory School of Medicine Atlanta Georgia USA"},{"name":"Emory Healthcare Veterans Program Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7056-5857","authenticated-orcid":false,"given":"Lauren M.","family":"Sippel","sequence":"additional","affiliation":[{"name":"Northeast Program Evaluation Center, Department of Veterans Affairs West Haven Connecticut USA"},{"name":"Department of Psychiatry Geisel School of Medicine at Dartmouth  Hanover New Hampshire USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Maples\u2010Keller","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Emory School of Medicine Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula P.","family":"Schnurr","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Geisel School of Medicine at Dartmouth  Hanover New Hampshire USA"},{"name":"Executive Division, Department of Veterans Affairs National Center for PTSD  White River Junction Vermont USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,12]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1080\/20008066.2025.2485513"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2023.102300"},{"key":"e_1_2_5_4_1","doi-asserted-by":"crossref","unstructured":"Alpert M. 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