Ketamine as a Novel Psychopharmacotherapy for Eating Disorders: Evidence and Future Directions.

Summary

Eating disorders are serious psychiatric conditions with limited treatment options. Ketamine, a drug approved for treatment-resistant depression, is now being investigated for eating disorders. This review examines the evidence for ketamine in treating anorexia nervosa, bulimia nervosa, and binge eating disorder. Results are encouraging but limited to case reports on anorexia nervosa. More research is needed to determine ketamine's effectiveness across different eating disorder types, establish safety, and optimize dosing.

Study at a glance

Abstract

Eating disorders (EDs) are serious, life-threatening psychiatric conditions associated with physical and psychosocial impairment, as well as high morbidity and mortality. Given the chronic refractory nature of EDs and the paucity of evidence-based treatments, there is a pressing need to identify novel approaches for this population. The noncompetitive N-methyl-D-aspartate receptor (NMDAr) antagonist, ketamine, has recently been approved for treatment-resistant depression, exerting rapid and robust antidepressant effects. It is now being investigated for several new indications, including obsessive-compulsive, post-traumatic, and substance use disorder, and shows transdiagnostic potential for EDs, particularly among clinical nonresponders. Hence, the aim of this review is to examine contemporary findings on the treatment of EDs with ketamine, whether used as a primary, adjunctive, or combination psychopharmacotherapy. Avenues for future research are also discussed. Overall, results are encouraging and point to therapeutic value; however, are limited to case series and reports on anorexia nervosa. Further empirical research is thus needed to explore ketamine efficacy across ED subgroups, establish safety profiles and optimize dosing, and develop theory-driven, targeted treatment strategies at the individual patient level.