Psilocybin therapy and anorexia nervosa: a narrative review of safety considerations for researchers and clinicians.

Clinical trials are testing psilocybin therapy for anorexia nervosa (AN), but individuals with AN have unique medical vulnerabilities. This review describes how common physiologic adverse effects of psilocybin—tachycardia, hypertension, electrocardiogram changes, nausea, headache, and lightheadedness—may interact with medical complications seen in AN. It proposes risk mitigation strategies for each adverse effect. Early evidence suggests psilocybin therapy is well-tolerated in individuals with AN. Understanding AN's medical complications in relation to psilocybin's effects can help tailor strategies to enhance safety and tolerability of this novel intervention.

Study at a glance

Abstract

Clinical trials using psilocybin therapy to treat anorexia nervosa (AN) are currently underway. The safety and tolerability of psilocybin is of utmost importance in individuals with AN who may present unique medical vulnerabilities. The purpose of this review is to describe how the common physiologic adverse effects of psilocybin may impact medical complications experienced by individuals with AN in clinical trials of psilocybin therapy. The physiologic underpinnings of common adverse effects following psilocybin administration are described, including tachycardia, hypertension, electrocardiogram changes, nausea, headache, and lightheadedness. These anticipated physiologic changes are described in relation to the common medical correlates seen in individuals with AN. Risk mitigation strategies for each adverse effect are proposed. Early evidence suggests that psilocybin therapy is well-tolerated in individuals with AN. Understanding the unique medical complications of AN, and how they may be impacted by common physiologic adverse effects of psilocybin administration, leads to tailored risk mitigation strategies to enhance safety and tolerability of this novel intervention.