Nutrients
November 20, 2021
Johanna Louise Keeler, Janet Treasure, Mário F. Juruena et al.
55 citations
Anorexia nervosa is difficult to treat, especially in severe and enduring cases. Malnutrition and weight loss can reduce grey and white matter in the brain, impair neuroplasticity and neurogenesis, and cause difficulties with cognitive flexibility, memory, and learning. Depression is highly comorbid and may hinder recovery, but traditional antidepressants are often ineffective in underweight patients. This review presents a conceptual overview for treating anorexia nervosa with ketamine. Ketamine has rapid antidepressant effects hypothesized to occur via increased glutamate, leading to increased neuroplasticity, neurogenesis, and synaptogenesis. The article covers ketamine's use for common psychiatric comorbidities and discusses safety concerns. There appears ample theoretical background to warrant exploring ketamine as a treatment for adults with anorexia nervosa.
European Eating Disorders Review
October 12, 2023
Johanna Louise Keeler, Carol Kan, Janet Treasure et al.
36 citations
Treatment for anorexia nervosa remains challenging due to limited approved medications and variable psychotherapy effectiveness. Converging evidence indicates deficiencies in neuroplasticity during acute stages of the disorder. This review covers neuroimaging, neuropsychological, molecular, and qualitative findings on neuroplasticity in anorexia nervosa. Novel pharmacological approaches that may address these deficits include ketamine, psilocybin, and human recombinant leptin; anti-inflammatory drugs and brain-derived neurotrophic factor mimetics might become viable after further research. Psychotherapeutic strategies targeting neuroplastic deficiencies and broader identity issues include imagery rescripting, memory specificity training, cognitive remediation therapy, exposure therapies, narrative therapies, cultural interventions, and yoga or mindfulness-based approaches. Longitudinal studies with large samples and feasibility trials are needed to advance translation.
Pharmacological Research
May 14, 2025
Rebecca Morris, Janet Treasure, Hubertus Himmerich et al.
4 citations
People with eating disorders often also have anxiety disorders, which can worsen eating disorder symptoms and interfere with treatment. This systematic review examined 51 studies on medications for anxiety in people with eating disorders. Results were mixed: fluoxetine helped anxiety in anorexia and bulimia nervosa but not binge eating disorder; olanzapine showed benefits for anxiety in anorexia nervosa, with preliminary case reports suggesting its use in ARFID. Early evidence for psilocybin and ketamine reported favorable anxiety outcomes in anorexia nervosa patients. More randomized controlled trials are needed to establish efficacy and safety.
BMC medicine
May 19, 2026
Rebecca Morris, Ayse Gundogan, Vanessa Lawrence et al.
A meta-ethnography of eight qualitative studies examined how people with eating disorders and their providers experience psychedelic-assisted therapy. Five meta-themes emerged: core transformative processes (Mind-Body-Spirit, Emotional Processing) unfold within specific contextual conditions (Navigating Challenges and Risks, Enabling Safe and Supportive Experiences) and lead to meaningful outcomes (Therapeutic Improvements). Psychedelics may improve emotion processing and enhance perception of and connection with the body and self, which is pertinent to eating disorder recovery. However, low weight and physical vulnerabilities increase risks for adverse side effects. To achieve therapeutic outcomes, eating-disorder-specific contextual conditions are required, including dual competency in psychedelic treatment and eating disorder psychopathology.