Ketamine as a Novel Psychopharmacotherapy for Eating Disorders: Evidence and Future Directions

Introduction

Eating disorders (EDs) are common, disabling psychiatric conditions with complex aetiology, high morbidity and mortality, and substantial personal and economic burden. Existing treatments rely primarily on psychotherapies and nutritional management, with pharmacological options showing only modest benefits for bulimia nervosa (BN) and binge eating disorder (BED) and effectively no approved agents for anorexia nervosa (AN). Given frequent chronicity, low remission rates and a subgroup of severe and enduring illness that is treatment‑refractory, there is a pressing need for novel therapeutic approaches that can address both core ED psychopathology and common comorbidities such as depression and suicidality. This review examines contemporary evidence on ketamine, a noncompetitive N‑methyl‑D‑aspartate receptor (NMDAr) antagonist with rapid antidepressant effects, as a potential treatment for EDs. The authors set out to summarise published clinical reports in which ketamine was used as a primary, adjunctive, or combined pharmacotherapy for EDs, to identify patterns in dosing and outcomes, and to outline directions for future empirical work. The paper emphasises the transdiagnostic rationale for ketamine in EDs while noting that existing studies are preliminary and concentrated mainly on AN.