Psilocybin promising treatment for anorexia nervosa, reveals first clinical trial

In a groundbreaking exploration of psychedelic medicine's potential for treating one of psychiatry's most challenging conditions, researchers at University of California, San Diego (UCSD) provided an analysis and further details of a trial published in Nature Medicine that had shown how psilocybin therapy affects individuals with anorexia nervosa. In the new peer-reviewed Emerging Topic article in Psychedelics the authors of the original trial offer “a granular view of findings based on qualitative data from semi-structured interviews, extensive feedback and interviews from participants, and [their] subjective interpretations of data patterns.” This new Emerging Topic review reveals both promising outcomes and important limitations that could shape future treatment approaches.

The study, published November 7, 2024, in Psychedelics, offers a unique first-hand perspective on how psilocybin treatment impacts patients with anorexia nervosa, a condition that maintains the highest mortality rate among psychiatric illnesses and has historically resisted conventional treatments.

“Our findings suggest that psilocybin may be helpful in supporting meaningful psychological change in a subset of people with anorexia nervosa,” says Dr. Stephanie Knatz Peck, lead author of the study. “What's particularly interesting is that 60% of participants reported a reduction in the importance of physical appearance, while 70% noted quality-of-life improvements and shifts in personal identity.”

Key findings from the trial include:

• 90% of participants ranked their psilocybin session among their top five most meaningful life experiences

• Four out of ten participants showed clinically significant reductions in eating disorder psychopathology

• Treatment effects were most pronounced in shape and weight concerns

• Changes in psychological outlook didn't automatically translate to weight restoration

The research raises intriguing questions about the intersection of psychedelic medicine and eating disorder treatment. Why do some patients respond dramatically while others show minimal improvement? How might genetic variations in serotonin receptors influence treatment outcomes?

“You are able to act in a way that maybe had felt unachievable before if you set the right intention,” reported one participant, while another noted, “Things might not look that different from the outside, but they feel completely different from the inside.”

The study employed a single 25mg dose of psilocybin combined with specialized psychological support before, during, and after administration. While the results show promise, they also highlight the complexity of treating anorexia nervosa, suggesting that psychedelic therapy might work best as part of a comprehensive treatment approach rather than a standalone intervention.

Dr. Walter H. Kaye, senior author and director of the UCSD Eating Disorders Treatment Center, emphasizes the need for larger, well-controlled studies that include brain imaging and genetic analysis to better understand who might benefit most from this novel treatment approach.

The findings open new avenues for research into personalized medicine approaches for eating disorders, while also raising important questions about how to optimize therapeutic protocols for this vulnerable population.

Reference:

Stephanie Knatz Peck, Hannah Fisher, Jessie Kim, Samantha Shao, Julie Trim, and Walter H. Kaye, Psychedelic treatment for anorexia nervosa: A first-hand view of how psilocybin treatment did and did not help, Psychedelics, https://doi.org/10.61373/pp024e.0034.