Ketamine as a Treatment for Anorexia Nervosa: A Narrative Review
This review (2021) explores the use of ketamine to treat Anorexia Nervosa (AN). The ability of ketamine to induce neuroplasticity, neurogenesis and synaptogenesis is discussed in relation to AN. Furthermore, the known antidepressant effects of ketamine may be beneficial to people with AN as depression is often experienced comorbidly.
Authors
- Keeler, J. L.
- Treasure, J.
- Juruena, M. F.
Published
Abstract
Anorexia nervosa (AN) is a highly complex disorder to treat, especially in severe and enduring cases. Whilst the precise aetiology of the disorder is uncertain, malnutrition and weight loss can contribute to reductions in grey and white matter of the brain, impairments in neuroplasticity and neurogenesis and difficulties with cognitive flexibility, memory and learning. Depression is highly comorbid in AN and may be a barrier to recovery. However, traditional antidepressants are often ineffective in alleviating depressive symptoms in underweight patients with AN. There is an urgent need for new treatment approaches for AN. This review gives a conceptual overview for the treatment of AN with ketamine. Ketamine has rapid antidepressant effects, which are hypothesised to occur via increases in glutamate, with sequelae including increased neuroplasticity, neurogenesis and synaptogenesis. This article provides an overview of the use of ketamine for common psychiatric comorbidities of AN and discusses particular safety concerns and side effects. Potential avenues for future research and specific methodological considerations are explored. Overall, there appears to be ample theoretical background, via several potential mechanisms, that warrant the exploration of ketamine as a treatment for adults with AN.
Research Summary of 'Ketamine as a Treatment for Anorexia Nervosa: A Narrative Review'
Introduction
Ketamine is an NMDA receptor antagonist originally developed as an anaesthetic and available as a racemic mixture and as enantiomers (esketamine and arketamine). Keeler and colleagues outline its pharmacology, routes of administration and metabolism, noting wide variation in bioavailability by route (e.g. IV 100%, intranasal 30–50%, oral 10–20%) and a short half-life for racemic ketamine (2–4 h) with active metabolites such as norketamine and hydroxynorketamines that may contribute to clinical effects. The review also highlights the importance of psychological context (set and setting) for ketamine experiences and that different administration routes produce differing tolerability and logistical considerations in clinical practice. This narrative review aims to integrate evidence from neurobiology, clinical trials and translational studies to present a conceptual rationale for investigating ketamine as a treatment for adults with anorexia nervosa (AN). The authors set out to examine mechanisms by which ketamine might address core neurobiological and psychological features of AN, to summarise existing clinical evidence, and to identify safety considerations and priorities for future research.
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Study Details
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- APA Citation
Keeler, J. L., Treasure, J., Juruena, M. F., Kan, C., & Himmerich, H. (2021). Ketamine as a Treatment for Anorexia Nervosa: A Narrative Review. Nutrients, 13(11), 4158. https://doi.org/10.3390/nu13114158
References (28)
Papers cited by this study that are also in Blossom
Mcintyre, R. S., Rosenblat, J. D., Nemeroff, C. B. et al. · American Journal of Psychiatry (2021)
Zanos, P., Moaddel, P. J., Morris, P. J. et al. · Nature (2016)
Taylor, J. H., Landeros-Weisenberger, A., Coughlin, C. et al. · Neuropsychopharmacology (2017)
Ezquerra-Romano, I. I., Lawn, W., Krupitsky, E. M. et al. · Neuropharmacology (2018)
Jones, J. L., Mateus, C. F., Malcolm, R. J. et al. · Frontiers in Psychiatry (2018)
Worrell, S. D., Gould, T. J. · Neuroscience and Biobehavioral Reviews (2021)
Feder, A., Parides, M. K., Murrough, J. W. · JAMA Psychiatry (2014)
Leary, T., Litwin, G. H., Metzner, R. · Journal of Nervous and Mental Disease (1977)
Hartogsohn, I. · Drug Science Policy and Law (2017)
Johnson, M. W., Richards, W. A., Griffiths, R. R. · Journal of Psychopharmacology (2008)
Show all 28 referencesShow fewer
Carhart-Harris, R. L., Roseman, L., Haijen, E. C. H. M. et al. · Journal of Psychopharmacology (2018)
Andrade, C. · Journal of Clinical Psychiatry (2017)
Dakwar, E., Anerella, C., Hart, C. L. et al. · Drug and Alcohol Dependence (2014)
Kiraly, D. D., Horn, S. R., Van Dam, N. T. et al. · Translational Psychiatry (2017)
Short, B., Fong, J., Galvez, V. et al. · Lancet Psychiatry (2017)
Sos, P., Klirova, M., Novák, T. et al. · Neuropsychiatric Disease And Treatment (2013)
Luckenbaugh, D. A., Niciu, M. J., Ionescu, D. F. et al. · Journal of Affective Disorders (2014)
Belser, A. B., Agin-Liebes, G. I., Swift, T. C. et al. · Journal of Humanistic Psychology (2017)
Griffiths, R. R., Johnson, M. W., Richards, W. A. et al. · Psychopharmacology (2011)
Martinotti, G., Pettorruso, M. · Brain Sciences (2021)
Girgenti, M. J., Ghosal, S., Lopresto, D. et al. · Neurobiology of Disease (2017)
Asim, M., Wang, B., Hao, B. et al. · Neurochemistry International (2021)
du Jardin, K. G., Müller, H. K., Elfving, B. et al. · Progress in Neuro-Psychopharmacology and Biological Psychiatry (2016)
Kotoula, V., Stringaris, A., Mackes, N. et al. · Biological Psychiatry (2022)
Abdallah, C. G., Jackowski, A., Salas, R. et al. · Neuropsychopharmacology (2017)
Mollaahmetoglu, O. M., Keeler, J., Ashbullby, K. J. et al. · Frontiers in Psychiatry (2021)
Harding, F., Seynaeve, M., Keeler, J. et al. · Journal of Integrative Neuroscience (2021)
Abdallah, C. G., Charney, D. S., Duman, R. S. et al. · Neuron (2019)
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