Pharmacotherapeutic strategies for the treatment of anorexia nervosa - novel targets to break a vicious cycle.
Expert opinion on pharmacotherapy – December 01, 2024
Source: PubMed
Summary
Despite being the deadliest eating disorder, anorexia nervosa may soon have new treatment options. Emerging research shows promising results using innovative approaches like ketamine, psychedelics, and ketogenic nutrition alongside traditional therapies. These treatments target both the neurobiological basis of anorexia and common co-occurring conditions like anxiety and depression.
Abstract
Anorexia nervosa (AN) has one of the highest mortality rates of all mental illnesses. No approved pharmacological treatments exist for AN, but novel neurobiological targets show promise. Studies show that in individuals with AN, there are alterations in brain neurotransmitter signaling, alongside associated mental rigidity and comorbid anxiety and depression. Available and new therapies could be used to improve alterations in neurobiology and behavior. This narrative review serves as a review of previously published literature assessing the efficacy of traditional pharmacotherapy in treating AN while also exploring novel treatments, including dissociative anesthetics, psychedelics, cannabinoids, hormones, neurosteroids, and ketogenic nutrition. If best practice psychotherapeutic interventions have failed, we recommend a neuroscience and brain research-based medication approach that targets dopamine neurotransmitter receptors to enhance cognitive flexibility and illness insight while reducing dread and avoidance toward food. It is furthermore essential to recognize and treat comorbid conditions such as anxiety, depression, or obsessive-compulsive disorder as they interfere with recovery, and typically do not resolve even with successful AN treatment. Novel strategies have the promise to show efficacy in improving mood and reducing specific AN psychopathology with hopes to be used in clinical practice soon.