Psilocybin in the treatment of eating disorders: a systematic review of the literature and registered clinical trials
Eating and Weight Disorders - Studies on Anorexia Bulimia and Obesity – July 29, 2025
Source: OpenAlex
Summary
With Fluoxetine the only pharmacological treatment approved for Bulimia Nervosa, and no drugs for other eating disorders like Anorexia Nervosa, new options are crucial. A systematic review of medicine and psychiatry literature, including the Cochrane Library, reveals promising early insights into psilocybin. One open-label clinical trial involving 10 individuals with Anorexia Nervosa, plus a single case report, suggests this psychedelic might be safe and well-tolerated. Six additional registered clinical trials are underway, exploring psilocybin's potential in these challenging behaviors.
Abstract
Abstract Background Fluoxetine remains the only pharmacological treatment approved for Bulimia Nervosa, and no other drugs have been approved for eating disorders (EDs). The rationale for exploring psilocybin as a treatment for EDs is compelling, both from biological and psychological perspectives. Moreover, its safety profile in healthy individuals appears favorable. This systematic review aims to examine original research articles and registered clinical trials to assess the current psilocybin’s therapeutic potential in EDs. Methods Systematic review following the indications of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched PubMed, Excerpta Medica Database (EMBASE), and the Cochrane Library from inception until 29 July 2024, with key terms: “psilocybin” and “eating disorders”. Quality was assessed through the Quality Assessment Tool for Before–After (Pre–Post) Studies With No Control Group released by the National Heart, Lung, and Blood Institute (NHLBI). We performed an additional search on the registry of clinical trials available at the website https://clinicaltrials.gov . Results Two studies met the inclusion criteria for our analysis. The first was an open-label feasibility study involving 10 individuals with Anorexia Nervosa (AN), without a control group. The second was a single case report describing the use of psilocybin in a person with AN. In addition, six registered clinical trials of psilocybin in individuals with EDs were identified. Conclusions The initial evidence shows that psilocybin might be safe and well-tolerated in AN. The promising results and the need for tests in enlarged samples encourage further research on psilocybin in EDs. Level of evidence VIII Evidence from nonrandomized controlled clinical trials, nonrandomized clinical trials, cohort studies, case series, case reports, and individual qualitative studies.