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

PTSD and alcohol use disorder often co-occur in trauma-exposed patients, creating a cycle where PTSD symptoms drive heavy drinking and vice versa. No FDA-approved medications exist specifically for this comorbidity; patients receive treatments approved for each disorder separately or off-label, which have limited efficacy. Emerging research suggests the psychedelic drug MDMA, used with psychotherapy, may be effective. This review examines current pharmacotherapies and MDMA-integrative psychotherapy for PTSD and AUD both individually and together, and discusses future directions for psychedelic-integrative therapy in treating this comorbidity.

Study at a glance

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.