Ketamine as a Novel Psychopharmacotherapy for Eating Disorders: Evidence and Future Directions

Summary & key facts

This paper reviews early research on using ketamine — a drug that blocks a brain receptor called NMDA and is already approved for hard-to-treat depression — to treat eating disorders. The authors found some encouraging signs, especially for people who did not get better with usual treatments, but most evidence comes from a few case reports and small case series mostly about anorexia nervosa. The review says more careful studies are needed to know whether ketamine is safe, how much to give, which types of eating disorders it might help, and how best to combine it with other therapies.

Key facts:

• Ketamine is a medicine that blocks a brain receptor called NMDA and is already approved for people with depression who did not get better with other treatments.
• Researchers are testing ketamine for several conditions beyond depression, including obsessive-compulsive disorder, post-traumatic stress disorder, and substance use problems.
• Early findings suggest ketamine might have benefits for some people with eating disorders, especially those who have not responded to usual treatments.
• Most of the evidence so far comes from case reports and small case series, mainly studying people with anorexia nervosa, not from large controlled trials.
• The authors say more research is needed to prove whether ketamine works across different eating disorder types, to check safety, to find the best dose and schedule, and to build treatments tailored to each patient.

Abstract

Eating disorders (EDs) are serious, life-threatening psychiatric conditions associated with physical and psychosocial impairment, as well as high morbidity and mortality. Given the chronic refractory nature of EDs and the paucity of evidence-based treatments, there is a pressing need to identify novel approaches for this population. The noncompetitive N-methyl-D-aspartate receptor (NMDAr) antagonist, ketamine, has recently been approved for treatment-resistant depression, exerting rapid and robust antidepressant effects. It is now being investigated for several new indications, including obsessive-compulsive, post-traumatic, and substance use disorder, and shows transdiagnostic potential for EDs, particularly among clinical nonresponders. Hence, the aim of this review is to examine contemporary findings on the treatment of EDs with ketamine, whether used as a primary, adjunctive, or combination psychopharmacotherapy. Avenues for future research are also discussed. Overall, results are encouraging and point to therapeutic value; however, are limited to case series and reports on anorexia nervosa. Further empirical research is thus needed to explore ketamine efficacy across ED subgroups, establish safety profiles and optimize dosing, and develop theory-driven, targeted treatment strategies at the individual patient level.

Topics

Eating Disorders and Behaviors Obsessive-Compulsive Spectrum Disorders Treatment of Major Depression

Categories

Clinical Psychology Psychology Social Sciences

Tags

Anorexia nervosa Bulimia nervosa Clinical psychology Dosing Eating disorders Environmental health Ketamine Medicine Pharmacology Population Psychiatry Psychology Psychosocial Psychotherapist

Substances

Ketamine

Conditions & symptoms

Depression Eating Disorder Obsessive-Compulsive Disorder PTSD Substance abuse disorder Poor appetite or overeating Sadness or low mood