Psilocybin as a Novel Pharmacotherapy for Treatment-Refractory Anorexia Nervosa
This review (2021) appraises psilocybin as a novel pharmacotherapy for treatment-resistant anorexia nervosa (AN). It observes that classic psychedelics like LSD, 5-MeO-DMT, DMT, and psilocybin show a significant decrease in anxiety and depression-like symptoms, and lasting improvement in mental health. The review suggests that classic psychedelics, psilocybin in particular, show promise in normalizing dysfunctional neurobiological systems in AN and point towards a novel treatment intervention for treatment-resistant patients.
Authors
- Rodan, S.
- Aouad, P.
- McGregor, I. S.
Published
Abstract
Anorexia Nervosa (AN) is a major health problem with one of the highest mortalities and treatment costs of any psychiatric condition. Cognitive behavioural therapy (CBT) is currently the most widely used treatment for AN in adults but provides remission rates ≤ 50%. Treatment drop-out is exceedingly high and those that persevere with treatment often relapse, causing increased risk of morbidity and mortality. There is an urgent need to find new interventions, especially as there are no approved pharmacological treatments for AN. Ideally, new treatments would target treatment-resistance and to decrease the chronicity associated with the disorder. Over the past two decades, emerging research into classic psychedelic substances (lysergic diethylamide acid (LSD), 5-Methoxy-N,N-Dimethyltryptamine (5-MeO-DMT), N,N-Dimethyltryptamine (DMT) and psilocybin), indicates that marked reductions in anxiety and depression-like symptoms, and lasting improvement in mental health, can follow from one or two exposures to these psychedelic substances. Anxiety and depression are the most prevalent co-morbid psychiatric symptoms in AN. Here we suggest that classic psychedelics, particularly psilocybin, have the potential to normalise dysfunctional neurobiological systems in AN and provide a novel treatment intervention that is worthy of consideration, particularly for treatment-resistant patients.
Research Summary of 'Psilocybin as a Novel Pharmacotherapy for Treatment-Refractory Anorexia Nervosa'
Introduction
Rodan and colleagues frame anorexia nervosa (AN) as a severe, treatment‑resistant psychiatric disorder with very high morbidity, mortality and health‑care costs, and with few effective pharmacological options. They note that adult psychotherapies such as cognitive behavioural therapy (CBT) produce modest remission rates (typically ≤ 50%) and high drop‑out and relapse rates, and that an urgent need exists for novel interventions that can address treatment resistance and chronicity in AN. The introduction also summarises a resurgence of clinical interest in classic psychedelics over the past two decades, especially psilocybin, which has shown rapid, durable reductions in anxiety and depression after one or two doses in several preliminary studies; because anxiety and depression are common and prognostically important co‑morbidities in AN, this literature is positioned as clinically relevant. This review sets out to examine the therapeutic rationale for applying psilocybin to treatment‑refractory AN. The authors aim to integrate clinical, preclinical and neurobiological evidence on psilocybin — covering acute effects, safety, mechanisms (serotonergic modulation, network connectivity, neuroplasticity) and outcomes in conditions that commonly co‑occur with AN — to assess whether psilocybin‑assisted therapy warrants clinical investigation in AN and to identify key research questions and limitations for future trials.
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Study Details
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- APA Citation
Rodan, S., Aouad, P., McGregor, I. S., & Maguire, S. (2021). Psilocybin as a Novel Pharmacotherapy for Treatment-Refractory Anorexia Nervosa. OBM Neurobiology, 05(02), 1-25. https://doi.org/10.21926/obm.neurobiol.2102102
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