Ketamine as a Treatment for Anorexia Nervosa: A Narrative Review
Nutrients – November 20, 2021
Source: OpenAlex
Summary
Traditional antidepressants often fail to alleviate depression in Anorexia nervosa, a complex eating disorder where malnutrition impairs neuroplasticity and neurogenesis, affecting cognition. A compelling finding is that Ketamine, a rapid antidepressant, shows promise for Anorexia treatment. Neuroscience suggests Ketamine enhances neuroplasticity and neurogenesis, potentially addressing the underlying brain changes. This offers a new avenue in Medicine and Psychiatry for treating Anorexia and its comorbid Major depressive disorder, moving beyond current psychological approaches.
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.