Psychedelic drugs to treat depression
Researchers are exploring the science of psychedelic drugs as a potential treatment for depression. How effective could they be, and what are the regulatory and legal challenges in their use?
Researchers are exploring the role of psychedelic drugs as a treatment for eating disorders. How are eating disorders currently treated and what does the latest research on psychedelic drugs show?
DOI: https://doi.org/10.58248/RR12
POST has published briefings on the use of psychedelics to treat depressive disorders, anxiety disorders and PTSD. This is part of our wider work on the use of psychedelics to treat mental health conditions. POST will publish a major briefing on this later in 2024.
This briefing focusses specifically on eating disorders and covers:
Eating disorders can become long-term illnesses. A review reported that that two thirds of adults with anorexia nervosa, and one third with bulimia nervosa had not recovered after 9 years. The average duration of binge eating disorder is reported at 14 years. People with eating disorders are at increased risk of dying, particularly those with anorexia nervosa, when compared with people with other psychiatric illnesses.
There are no approved drug treatments approved in the UK to treat eating disorders. Where used, drugs are prescribed to treat co-existing mental health conditions such as anxiety and depression, which can be a barrier to recovery. There is specific interest as to whether psychedelic drugs can be as, or more, effective in this context.
In international medical diagnostic guidance (the ICD-11), feeding or eating disorders involve:
“abnormal eating or feeding behaviours that are not better accounted for by another medical condition and are not developmentally appropriate or culturally sanctioned. Feeding disorders involve behavioural disturbances that are not related to body weight or shape concerns, such as eating of non-edible substances or voluntary regurgitation of foods. Eating disorders involve abnormal eating behaviour and preoccupation with food accompanied in most instances by prominent body weight or shape concerns.”
There are seven disorders in the ICD-11, but the most common and the focus for psychedelic research are:
There are no drugs approved to treat eating disorders in the UK, but co-existing mental health conditions can be treated with drugs. This is important because conditions such as depression are likely to impede recovery.
Patient with eating disorders can also encounter a range of physical health issues due to their low weight, and abnormalities resulting from imbalances in levels of salts and minerals. These sometimes require inpatient treatment and dietary interventions, such as instigating regular eating. These are not included in this briefing. Information about supporting the physical health of patients with eating disorders is detailed here.
The research evidence examining psychedelic-assisted psychotherapy for eating disorders is less comprehensive than for other conditions. Most evidence comes from case reports (a study of one patient) or case series (a study of a small number of patients) or is cross-sectional (participants are observed at a single time point of time with no intervention).
This limits the strength of the conclusions that can be drawn as to the effectiveness of psychedelic drugs. However, a small number of clinical trials are underway.
Individual reports and survey data such as the above are prone to bias, which is why they are often used as the rationale for developing large, more robust clinical trials. For example, recruiting people to a survey based on them previously having used a psychedelic substance means they may be more likely to consider them favourably, possibly increasing the chances they will report improvement after their use.
Studies using robust research methods are needed. Early data has been published from some of these more robust clinical trials:
There are four trials assessing psilocybin as a treatment:
Two planned studies in Australia will also examine psilocybin-assisted therapy to treat anorexia nervosa.
A study by Lykos Therapeutics will begin in 2024. Recruiting 36 participants, it will examine MDMA-assisted psychotherapy to treat anorexia nervosa and binge eating disorder.
A study comparing oral ketamine to a placebo in 60 participants with both anorexia nervosa and major depressive disorder will begin in 2025 at King’s College London in collaboration with Neurocentrx Pharma Ltd.
POST is grateful to Dr Stephen Naulls, Clinical Research Fellow at POST, for researching this briefing.
POST would like to thank Hannah Douglass, PhD Student, Centre for Psychedelic Research, Division of Psychiatry at Imperial College London, and Dr Johanna Keeler, Postdoctoral Research Associate, Centre for Research in Eating and Weight Disorders, Institute of Psychiatry, Psychology & Neuroscience at King’s College London, who acted as external peer reviewers in preparation of this article.
Photo by: (© By Robert – stock.adobe.com).
Researchers are exploring the science of psychedelic drugs as a potential treatment for depression. How effective could they be, and what are the regulatory and legal challenges in their use?
How is PTSD treated, how successful are current treatments and what is the potential role for psychedelic-assisted therapy?
How are anxiety disorders treated, how successful are current treatments and what is the potential role for psychedelic-assisted therapy?