At a glance
- Compared with waiting
- In a 2026 trial of 20 adults, social anxiety fell much more with MDMA-assisted therapy than on a waiting list.
- Compared with other treatments
- Better than placebo in one MDMA pilot with 12 autistic adults. In one ketamine trial of 18 people, doctors rated improvement but people's own ratings did not change.
- Does it last
- In the MDMA pilot, gains held at 6 months.
- What it takes
- Not available as a treatment for social anxiety. MDMA and psilocybin are illegal in most countries outside research.
What it is
Several drugs are being studied as helpers for therapy, not as daily pills:
- MDMA-assisted therapy. MDMA is the drug known as ecstasy. In research, people take a measured dose in a clinic during a long therapy session, with therapists present. The idea is that it lowers fear and makes it easier to talk about painful things.
- Ketamine. An anaesthetic that some clinics use for depression. It has been tested once for social anxiety.
- Psilocybin. The active substance in “magic mushrooms”. It has been tested for depression, but not for social anxiety.
None of these is approved as a treatment for social anxiety. In 2024 the US Food and Drug Administration also turned down MDMA-assisted therapy for PTSD, asking for another large trial.
Why people are interested
Social anxiety often feels like a wall between you and other people. Stories of people feeling open and connected on MDMA make sense in that light. On Reddit, questions about MDMA and psilocybin trials for social anxiety come up often. The interest is real. The evidence is very thin.
What the trials found
- MDMA in autistic adults. In a US pilot trial, 12 autistic adults with social anxiety had MDMA-assisted therapy (8 people) or placebo with the same therapy (4 people). Social anxiety fell more in the MDMA group, and the gains held at 6 months. There were no serious side effects. But with 12 people, one or two unusual results can change the whole picture.
- MDMA in adults with social anxiety: a first trial. A trial in Portland, Oregon, called SAMATI, published its results in November 2026. 20 adults were randomly put into MDMA-assisted therapy or a 16-week waiting list. Social anxiety fell much more in the MDMA group, and there were no serious side effects. But there was no placebo, everyone knew which group they were in, and the authors call the results preliminary. The trial registry had planned for 90 people.
- Ketamine. In a US trial of 18 people, each person had ketamine once and a placebo once. Doctors rated more improvement after ketamine. But people’s own ratings of anxiety did not differ. And 17 of 18 people could tell when they had ketamine, so the trial was not truly blind. Knowing you got the “real” drug can change how you, and the doctor rating you, see the result.
- Psilocybin: no trials. A search of ClinicalTrials.gov in November 2026 found no registered psilocybin trial for social anxiety.
Why these trials are hard to trust yet
- They are tiny. Results from 12 or 18 people often shrink or vanish in bigger trials.
- People can tell which drug they got. These drugs have strong effects, so a dummy pill does not fool anyone. That makes a fair test hard.
- The therapy matters too. MDMA trials include many hours of therapy. Part of any benefit may come from that.
Risks
- These are powerful drugs. In trials, people are screened carefully and watched for hours. That is very different from taking them alone.
- Street drugs are unknown drugs. What is sold as MDMA or mushrooms may contain other substances or a very different dose.
- They are illegal in most countries outside research or special programmes.
- Mental health risks. Psychedelics can cause frightening experiences. People with a personal or family history of psychosis are usually excluded from trials.
If you take a prescribed medicine, talk to your doctor before trying anything new. Some antidepressants interact dangerously with MDMA. If you feel low or unsafe, see crisis lines.
How to take part in research
The safest way to try an experimental treatment is inside a trial. Search ClinicalTrials.gov for “social anxiety” and filter for studies that are recruiting. A trial team will check whether it is safe for you.
What helps now
Cognitive therapy for social anxiety and SSRIs have many trials behind them. See trials waiting for results for the studies we are watching.
Myths and facts
Myth:MDMA cures social anxiety.
Fact:The two published trials had 12 and 20 people. The bigger one compared MDMA with a waiting list, not with a placebo. These are early results, not proof.
Myth:Psychedelics are being trialled for social anxiety.
Fact:No psilocybin trial for social anxiety was registered on ClinicalTrials.gov in November 2026.
Sources
- Danforth AL, Grob CS, Struble C, et al. (2018). Reduction in social anxiety after MDMA-assisted psychotherapy with autistic adults: a randomized, double-blind, placebo-controlled pilot study.Psychopharmacology.
- Luoma JB (Portland Psychotherapy) (2025). Social Anxiety MDMA-Assisted Therapy Investigation (SAMATI) (NCT05138068).ClinicalTrials.gov.
- Luoma JB, Lear MK, Pilecki B, LeJeune J, Yi R, et al. (2026). MDMA-assisted therapy for social anxiety disorder: A randomized, open-label, wait-list controlled trial.Journal of Affective Disorders.
- Taylor JH, Landeros-Weisenberger A, Coughlin C, et al. (2018). Ketamine for Social Anxiety Disorder: A Randomized, Placebo-Controlled Crossover Trial.Neuropsychopharmacology.
- ClinicalTrials.gov API query by researcher (2026). Interventional studies with condition 'social anxiety disorder': counts by status and results.ClinicalTrials.gov API v2.
- Psychiatric Times: FDA issues complete response letter to Lykos for MDMA-assisted therapy (9 August 2024)