Psilocybin as a Novel Pharmacotherapy for Treatment-Refractory Anorexia Nervosa

Anorexia nervosa (AN) has high mortality and treatment costs, and cognitive behavioural therapy (CBT) achieves remission in at most 50% of adults. Drop-out and relapse rates are high, and no approved pharmacological treatments exist. Over the past two decades, research into classic psychedelics (LSD, 5-MeO-DMT, DMT, and psilocybin) shows that one or two exposures can produce lasting reductions in anxiety and depression, which are the most common co-morbid psychiatric symptoms in AN. The authors suggest that classic psychedelics, especially psilocybin, may normalize dysfunctional neurobiological systems in AN and offer a novel intervention, particularly for treatment-resistant patients.

Study at a glance

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.