Evidence mapPaperPMID 42422592Full record

ReviewTherapeutic advances in psychopharmacology2026

Making a case for using MDMA-assisted psychotherapy for borderline personality disorder and complex PTSD: a descriptive systematic review of the literature.

Karthika Kasiviswanathan, Dinuli Nilaweera, Melissa Morando, Sathya Rao, Jessica Lee, Joseph Fettling, Jillian H Broadbear

Abstract readReview
In one paragraph

Review in Therapeutic advances in psychopharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Karthika KasiviswanathanSpectrum Personality Disorder and Complex Trauma Service, Centre for Research and Innovation, 110 Church Street, Richmond, VIC 3121, Australia Monash University, Eastern Health Clinical School, Box Hill, VIC, Australia.ORCID https://orcid.org/0000-0001-8220-7627
Dinuli NilaweeraSpectrum Personality Disorder and Complex Trauma Service, Centre for Research and Innovation, Richmond, VIC, Australia.
Melissa MorandoSpectrum Personality Disorder and Complex Trauma Service, Centre for Research and Innovation, Richmond, VIC, Australia.
Sathya RaoSpectrum Personality Disorder and Complex Trauma Service, Centre for Research and Innovation, Richmond, VIC, Australia.
Jessica LeeSpectrum Personality Disorder and Complex Trauma Service, Centre for Research and Innovation, Richmond, VIC, Australia.
Joseph FettlingSpectrum Personality Disorder and Complex Trauma Service, Centre for Research and Innovation, Richmond, VIC, Australia.ORCID https://orcid.org/0009-0008-3993-2020
Jillian H BroadbearSpectrum Personality Disorder and Complex Trauma Service, Centre for Research and Innovation, Richmond, VIC, Australia.ORCID https://orcid.org/0000-0003-3342-5868

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: 3,4-Methylenedioxymethamphetamine (MDMA)-assisted psychotherapy (MDMA-AP) has demonstrated considerable efficacy in treating post-traumatic stress disorder (PTSD). PTSD and complex PTSD (CPTSD) frequently co-occur with borderline personality disorder (BPD), a complex disorder marked by emotional dysregulation, interpersonal difficulties and abandonment fears - often accompanied by suicidal and non-suicidal self-injury. While MDMA-AP is beneficial for PTSD and hypothesised to be effective for BPD, its application to CPTSD and BPD has not been systematically reviewed. Objectives: To systematically evaluate primary evidence on the use of MDMA-AP in treating PTSD, CPTSD, and BPD. Design: Descriptive systematic review. Data sources and methods: A systematic search of four databases (Ovid Medline, Embase, APA PsycINFO and CENTRAL) identified 24 eligible peer-reviewed studies published before 17 February 2025. Risk of bias and data extraction were conducted independently using standardised methods. Results: Of the 24 studies involving 335 participants, 15 reported outcomes from seven clinical trials, four were case reports, and five were non-randomised interventions. Four studies included participants with multiple forms of trauma, and three included those with dissociative PTSD. Most reported reduced PTSD symptoms post-intervention; some noted decreased dissociative symptoms at higher MDMA doses. Six studies did not exclude participants with BPD. Although none directly assessed MDMA-AP for CPTSD or BPD, improvements in emotional regulation, interpersonal functioning, identity coherence and abandonment concerns were reported. Adverse drug reactions were mild to moderate, although specific safety concerns remain. Conclusion: Findings from this review suggest that MDMA-AP may have applicability beyond PTSD, with potential benefits for CPTSD and BPD, offering preliminary insights to inform future research and clinical considerations. Protocol registration: PROSPERO ID: CRD42025594896.

Indexed as

3,4-methylenedioxymethamphetamine (MDMA)borderline personality disordercomplex PTSDposttraumatic stress disorderpsychotherapysystematic review

Identifiers

PMID42422592
PMCPMC13342383

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.