Psychedelics show promise for treating psychiatric disorders, but how participants are prepared (set) and the environment where the drug is taken (setting) vary widely across studies. This systematic review examined 27 articles covering 25 clinical trials with 763 participants. Participant selection and creating a safe environment were consistently reported, but other elements like monitor training (52% of studies), controlling visual distractions (64%), and ensuring a pleasant environment (68%) were less consistently described. Psilocybin was the most studied psychedelic (47% of trials). The lack of standardization in set and setting limits comparability and reproducibility, and harmonizing these aspects would improve future research.
Eating disorders severely harm physical health and daily functioning, and few effective treatments exist, especially for anorexia nervosa. In a case series of eight female patients aged 16 to 44 with anorexia nervosa, intravenous ketamine was added to usual care to target rigid, food-focused thoughts. Some sessions included psychomotor or psychological support for body image, self-esteem, and re-exposure to feared foods. Ketamine adjuvant treatment significantly improved body mass index, with a coefficient of 0.71, and showed a tendency to improve weight regain after the fourth or fifth infusion. It also reduced anorexia-related psychopathology and obsessive-compulsive symptoms like rumination and cognitive rigidity. Ketamine's pro-plasticity and pro-neurogenesis effects may underlie these benefits, suggesting it as a potential option after first-line treatment failure.