Psychedelic Therapy for PTSD

Psychedelic therapy is one of the most promising new treatments for PTSD currently being studied. 

If you’re interested in exploring psychedelic therapy as a treatment for post-traumatic stress disorder (PTSD), you’re probably wondering:  “Does psychedelic therapy for PTSD work?” or, “Should I take psychedelics for PTSD?” and, “Where can I find psychedelic therapy for trauma?” Psychedelic therapy is an increasingly popular option for individuals struggling with PTSD. Here’s everything you need to know before you start your journey.

Can you take psychedelics for PTSD?

Taking psychedelics for post-traumatic stress is most effective when paired with treatment, often referred to as psychedelic integration, with a qualified therapist or guide.  

Studies have shown the benefits of psychedelics like MDMA and psilocybin for treating PTSD. But in most studies conducted so far, psychedelic treatment for PTSD was accompanied by talk therapy.

What is psychedelic therapy for PTSD?

Psychedelic treatment for PTSD typically follows a four-step framework:

• Step 1: Education. First, a therapist or guide qualifies that their client is a good fit for psychedelic therapy. Then the client and their therapist or guide explore healing options, and consider the potential benefits and drawbacks of different forms of psychedelic therapy for PTSD.

• Step 2: Preparation (part of Integration). Once the client and therapist have agreed on a healing plan, the client attends one or more therapy sessions to help them prepare for their psychedelic journey. This is the stage for setting goals and expectations, and learning how the experience will fit within the wider context of therapy.

• Step: 3: Facilitation, or the Journey. The client undergoes the psychedelic experience. Following best practices, they take their journey under the supervision of at least two qualified therapists or guides. But in some cases, the client may take this step on their own, with a guide or “trip sitter” other than their therapist, then meet with their therapist for the fourth step.

• Step 4: Integration. Possibly the most important step in psychedelic therapy for PTSD, integration consists of one-on-one work with a therapist or healer to contextualize and interpret the psychedelic experience. The client’s experiences during a psychedelic journey may be confusing or distressing. It’s the therapist’s job to help the client fit these experiences into a larger framework, so difficult experiences become a source of new, actionable insights.

Psychedelics and post-traumatic stress don’t always mix well. Before undergoing psychedelic therapy for PTSD, consult with a qualified therapist and make sure it’s right for you.

How does psychedelic treatment for PTSD work?

The integration stage of psychedelic therapy helps clients draw insights from their experience, shift perspectives, and progress in their healing.

But the physical mechanisms of psychedelics, and the changes they may cause in the brain of a client, are still being studied. To date, there is no conclusive model explaining how psychedelics treat PTSD on a physical level.

Psychedelic therapy for veterans, including MDMA treatment for post-traumatic stress, has been a popular topic in mainstream media. And while psychedelic therapy for veterans shows promise, people serving in the military are not the only ones who suffer from PTSD. Modern studies try to look at a wide variety of personal experiences and forms of trauma and the efficacy of MDMA treatment for post-traumatic stress (as well as other forms of psychedelic therapy).

New studies are continuously underway. Here are some recent papers on PTSD and psychedelics:

• The Efficacy of Psychedelic-Assisted Therapy in Managing Post-traumatic Stress Disorder (PTSD): A New Frontier? Analyzing the impact of different substances on symptoms of PTSD, and demonstrating how researchers think psychedelics may affect the brains of those with PTSD, this is a good introduction and overview of the topic.

• Reviewing the Potential of Psychedelics for the Treatment of PTSD. As a deeper dive into psychedelic therapy and PTSD, this paper analyzes different clinical results and proposed mechanisms in the brain.  
  

• Long-term effects of psychedelic drugs: A systematic review. This paper covers therapy for many conditions, and not only PTSD. But it’s a fascinating look at the long-term effects psychedelic therapy may have on the brain.

What substances are used in psychedelic therapy for PTSD?

A variety of substances are used in psychedelic therapy for PTSD, but not all of them have been thoroughly studied.

Psilocybin for PTSD

Psilocybin, the active ingredient in psilocybin or “magic” mushrooms, may have beneficial effects on symptoms of PTSD when combined with integration therapy.

The client may take psilocybin orally in the form of dried mushrooms (sometimes powdered and made into capsule pills), or as synthetic psilocybin pills.

Here are some recent studies on the effects of psilocybin therapy on PTSD:

• Psilocybin for Trauma-Related Disorders. While there is still a relatively small amount of information to work from, this paper looks and the clinical results so far and concludes that there is good potential for using psilocybin therapy to treat PTSD.
  

• Mechanisms of psilocybin on the treatment of posttraumatic stress disorder. A study considering how psilocybin may affect the workings of the brain to alleviate symptoms of PTSD.

Ketamine for PTSD

Ketamine is a general anaesthetic and analgesic used on both animals and humans. It may be prescribed for off-label use to treat PTSD. It comes in powdered or liquid form, and in clinical settings it’s typically administered intravenously.

Some studies have shown the effectiveness of ketamine, coupled with psychotherapy, in treating PTSD. This particularly applies to acute cases where clients need immediate relief from symptoms:

• Ketamine as treatment for post-traumatic stress disorder: a review. A thorough overview of all studies done up to 2019 on the effects of ketamine therapy on PTSD.
  

• Effectiveness of Ketamine for the Treatment of Post-Traumatic Stress Disorder – A Systematic Review and Meta-Analysis. Another systematic review of data related to ketamine’s use for treating PTSD, this time completed by a different group of researchers and current up to 2024.

• Ketamine for Treatment of Posttraumatic Stress Disorder: State of the Field. A look at the current state of research into ketamine therapy for PTSD.

MDMA for PTSD

MDMA (3-4 methylenedioxymethamphetamine) is a synthetic psychoactive drug originally developed in the 1920s. Starting in the 1970s, it was used in clinical settings to enhance psychotherapy.

The chemical structure of MDMA is similar to both methamphetamine (a stimulant) and mescaline (a psychedelic), but it also has features in common with serotonin, dopamine, and norepinephrine.

In a clinical setting, MDMA is usually administered orally in pill form.

Numerous studies show that MDMA therapy may have beneficial effects for clients suffering PTSD:

• MDMA-assisted therapy for severe PTSD: a randomized, double-blind, placebo-controlled phase 3 study. A major clinical study of MDMA therapy and PTSD that has set the standard for current research.

• MDMA-Based Psychotherapy in Treatment-Resistant Post-Traumatic Stress Disorder (PTSD): A Brief Narrative Overview of Current Evidence. Compared to other forms of psychedelic therapy, there is a relatively long history of research into MDMA as a treatment for PTSD. This paper tracks research and results up to the present day.

• Effects of MDMA-assisted therapy for PTSD on self-experience. Reporting on a clinical study of MDMA treatment for PTSD, this paper looks especially at test subjects’ ratings of self-compassion and emotional control after having undergone MDMA therapy.

LSD for PTSD

Lysergic acid diethylamide (LSD) is a synthetic psychoactive drug originally developed in 1938 by Albert Hofmann. In the 1950s and 1960s it was widely studied in clinical trials, and used experimentally in psychotherapy.

LSD is a serotonin receptor agonist, meaning it binds to serotonin receptors in the user’s brain. Its exact mechanisms are not widely understood.

In clinical settings, LSD is usually administered orally in liquid, blotter, or pill form.

One recent study suggests LSD therapy may be effective in treating PTSD:

• Efficacy of Psychoactive Drugs for the Treatment of Posttraumatic Stress Disorder: A Systematic Review of MDMA, Ketamine, LSD and Psilocybin

Microdosing for PTSD

“Microdosing” refers to the method of taking small amounts of psychedelics on an ongoing basis. 

The dosage is low enough that it doesn’t lead to a full-blown psychedelic experience—the client is able to go about their daily routine while microdosing. But anecdotal evidence supports the idea that these small doses have an ongoing or cumulative effect treating symptoms of PTSD.

While there are no completed studies showing the positive impact of microdosing on PTSD, this systematic overview traces the history of microdosing and how it may serve to treat a variety of disorders: 

• The emerging science of microdosing: A systematic review of research on low dose psychedelics (1955–2021) and recommendations for the field

What are the effects of psychedelic treatment for PTSD?

Psychedelic therapy for PTSD differs from one client to the next based on the substance being used, the dosage, the therapeutic techniques or frameworks applied, and the severity of the symptoms.

In some cases—ketamine therapy, for instance—the experience may result an immediate, effective relief of symptoms like suicidal ideation.

In other cases—like microdosing—it may take months of ongoing psychedelic therapy before the client notices any changes.

Psychedelic experiences are highly subjective. One client may undergo a sudden mental or spiritual epiphany under the influence of psychedelics. Another client, with similar symptoms and the same dosage, may find their journey a frightening ordeal. 

In either case—”good trip” or “bad trip”—integration therapy is key. Through integration, clients and therapists work together to make sense of the psychedelic experience and use it for healing.

Psychedelic therapy and PTSD: Anecdotal evidence

No single description can capture the experience of undergoing psychedelic therapy for PTSD. 

To get a better sense of what it feels like, and the effects psychedelic healing for PTSD may have, it helps to turn to anecdotal evidence: 

• Nine veterans with PTSD went to Mexico for a psychedelic retreat. This is how they feel nearly a year later. This segment from 60 Minutes follows the healing journey of US Armed Forces veterans who underwent a form of psychedelic therapy for their PTSD.

• ‘I’m better mentally now’: Veteran shares experience of MDMA treatment for PTSD. The Today Show profiles a veteran who underwent MDMA therapy to treat his PTSD. 

• How a first responder says MDMA helped him get past PTSD. A first responder to a mass shooting who suffered from PTSD after the experience shares his MDMA treatment journey. From ABC News.

Psychedelics and antidepressants

There have been few studies done on the risks of combining psychedelics with antidepressants. 

Some therapists or guides recommend clients taper off psychopharmaceutical drugs before undergoing the psychedelic journey. There two good reasons for this:

• Serotonin syndrome. Certain psychedelics, such as MDMA or ayahuasca*, may react adversely with SSRIs and lead to serotonin syndrome, a serious and potentially fatal condition. 

• Dulled effects. Conversely, some SSRIs and other classes of antidepressants may dull the effects of psychedelics, leading to a less-than-optimal experience for the client undergoing psychedelic therapy.

* (Because they work differently from MDMA or ayahuasca (which contains MAOI inhibitors that may interact with antidepressants), psilocybin, LSD, and pure DMT do not typically increase the risk of serotonin syndrome when combined with antidepressants.)

Before you stop taking any drugs you’ve been prescribed to treat PTSD—whether by stopping all at once, or by tapering off your dosage—talk to your prescribing doctor. 

Quitting antidepressants may cause antidepressant discontinuation syndrome, which has wide ranging negative effects. It might also lead to an increase in depressive symptoms, including suicidal ideation.

Where to find psychedelic therapy for PTSD

Interested in trying psychedelic therapy for trauma? Before you begin your search for a qualified therapist, healer, or guide, it’s important to understand both the risks and benefits of psychedelic therapy.

For a start, check out our guide to everything Canadians need to know about psychedelic therapy.

Then visit First Session to find psychedelic therapists in Canada: 

The personal video interviews on First Session can help you get a sense of what it would be like to work one-on-one with different therapists—so you can spend less time searching online and more time getting help.

Key takeaways:

• On their own, psychedelics aren’t an effective way to manage PTSD—they need to be combined with one-on-one therapy from a qualified therapist, healer, or guide

• The integration stage of psychedelic therapy is crucial for examining and contextualizing a psychedelic experience

• Psychedelic treatment for PTSD affects each client differently; it’s impacted by the dosage, substance, and type of therapy being given

• The most common (and most studied) psychedelics used to treat PTSD are psilocybin and MDMA

• Before embarking on psychedelic therapy for trauma, take time to find a therapist who is right for you