Psilocybin, A new hope in treating Anorexia Nervosa

Anorexia Nervosa (AN) is an eating disorder presented by an abnormally low body weight, an intense fear of gaining weight and a distorted perception of weight. The psychiatric disorder is a greater threat with no proven treatments to reverse core symptoms and no medications approved by the US Food and Drug Administration.

Psilocybin is a popular hallucinogenic chemical found in mushrooms known as magic mushrooms. Eating mushrooms that contain psilocybin can have a variety of effects, ranging from euphoria to hallucinations. The therapeutic effects of Psilocybin is yet to be evaluated for many such psychiatric disorders.

A new study in Nature Medicine by Stephanie Knatz Peck and team suggests that psilocybin therapy is effective safe, tolerable and acceptable for female AN, which can be a turning point with given physiological dangers and problems with treatment engagement. This is the first data report on the effects of psilocybin therapy in AN in a clinical research trial. This open-label pilot study examined the safety and tolerability of administering psilocybin therapy to participants with AN and pAN (partial remission).

Researchers conducted an open-label feasibility study, 10 adult female participants (mean body mass index 19.7 kg m−2; s.d. 3.7) who met Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for AN or pAN were recruited to a study conducted at an academic clinical research institute. Participants received a single 25-mg dose of synthetic psilocybin in conjunction with psychological support.

The key findings of the study are

• The researchers primarily aimed to assess safety, tolerability and feasibility at post-treatment by incidences and occurrences of adverse events (AEs) and clinically significant changes in electrocardiogram (ECG), laboratory tests, vital signs and suicidality.

• No clinically significant changes were observed in ECG, vital signs or suicidality. Two participants developed asymptomatic hypoglycemia at post-treatment, which resolved within 24 h.

• No other clinically significant changes were observed in laboratory values.

• All AEs were mild and transient in nature. Participants qualitative perceptions suggest that the treatment was acceptable for most participants.

Peck and team concluded that these “Results suggest that psilocybin therapy is safe, tolerable and acceptable for female AN, which is a promising finding given physiological dangers and problems with treatment engagement.” However results of this study are preliminary and inconclusive given its size and design.

Reference: Peck, S.K., Shao, S., Gruen, T. et al. Psilocybin therapy for females with anorexia nervosa: a phase 1, open-label feasibility study. Nat Med (2023). https://doi.org/10.1038/s41591-023-02455-9.