Esketamine, MDMA-AT

Hi everyone,

I’m a 37-year-old man with complex PTSD and chronic dissociation due to prolonged trauma. Currently, I’m on 300 mg venlafaxine, and my psychiatrist has suggested starting Spravato (esketamine) in a hospital setting. It’s safe, legal, and covered by insurance.

On the other hand, I also have access to a therapist offering MDMA-AT (MAPS-IFS trained) in an underground setting. While I feel that MDMA-AT might be more effective for trauma, there are downsides like the high cost (!), lack of medical supervision, and the more informal environment (issue with trust).

I understand many people here are strongly pro-MDMA-AT, but I’d appreciate if you could help me weigh both options. Esketamine in a controlled setting might help strengthen me for MDMA-AT in the future. It could offer me an introduction to altered states of consciousness in a safer, professional environment.

Has anyone had experience with both treatments? I’d love to hear your insights.