Anorexia nervosa has the highest mortality rate of any psychiatric disorder; however, there are no currently no proven treatments to reverse the main symptoms, nor are there any approved medications to treat this potentially life-threatening mental illness. However, a recent study has found that a single dose of psilocybin, the main compound found in magic mushrooms, may be an effective treatment option in patients with anorexia. This breakthrough in mental healthcare allows anorexia patients a promising new treatment for a condition that’s otherwise difficult to manage.
Psychedelics like psilocybin and MDMA have demonstrated promise in treating various mental health conditions, especially when combined with psychotherapy. Both substances have been granted the status of breakthrough therapy by the U.S. Food and Drug Administration (FDA) for their ability to treat certain mental illnesses more effectively than any other current treatments. Several prior studies have investigated the efficacy of psilocybin on eating disorders like anorexia, reporting similar themes of increased self-acceptance and positive mood while reducing symptoms in individuals with these conditions.
The symptoms of anorexia can lead to repetitive behavioral patterns due to excessive fear and distress concerning food, body shape, weight, and eating. Several clinical trials have found psilocybin therapy has been shown to improve anxiety, openness, and cognitive flexibility, which may help in disrupting these preoccupations and behavioral patterns, especially when combined with psychiatric therapy that directly targets these behaviors.
So how does a psychedelic compound extracted from mushrooms help treat one of the world’s most deadly mental health disorders?
To understand how psilocybin helps reduce symptoms of anorexia, it’s crucial to examine its mode of action. When psilocybin is ingested, it is converted by the body into an active compound called psilocin. The compound interacts with several receptors in the brain, notably the serotonin 2A receptor (5-HT2A). This receptor is one of the fifteen serotonin receptors. As a neurotransmitter, serotonin is responsible for regulating mood, emotions, and many other physiological processes. Psilocin binds with the 5-HT2A receptor, triggering neuronal circuits and leading to a series of changes within the brain.
It is believed that psilocybin can enhance neural plasticity, which can help break rigid thought patterns that can contribute to lasting eating disorder symptoms. Since negative patterns can become deeply ingrained into the brain’s neural circuits, psilocybin can help disrupt harmful patterns (1). The compound has also been found to increase communication within the brain, allowing for connections that have not yet been considered before. With the help of trained therapists, patients can explore new perspectives and train their minds to break free from negative behaviors and thought loops.
The phase 1 open-label feasibility study, published in Nature Medicine, examined the safety, tolerability, and effects of psilocybin therapy on females with anorexia or in partial remission (2). Ten women with the condition were given a single dose of an investigational drug called COMP360, a pharmaceutical-grade synthetic psilocybin developed by COMPASS Pathways. In a previous study, COMP360 psilocybin treatment has shown success at alleviating symptoms of treatment-resistant depression.
The treatment was given in a controlled setting with psychological support from trained clinicians.
A month after receiving treatment, patients reported substantial changes during their follow-up visit. Compared to the baseline (day 1 of receiving treatment), the patients noticed a meaningful reduction of ED symptoms and a significant decrease in weight concerns and body image concerns.
During the three-month follow-up, the patients reported improved changes in eating concerns. 40% of the participants saw a clinically significant reduction in eating disorder psychopathology. There were no drastic changes in the participant’s BMI scores; however, half of the participants had an increase in BMI during the three-month follow-up.
Additionally, 90% of participants felt more optimistic about their life endeavors, 80% felt as though the experience was one of the top five most meaningful experiences in their life, and 70% reported a shift in identity and overall quality of life.
The treatment was well tolerated, and there were no serious adverse events reported by any of the participants. But most of the participants felt that more than one dosing session was needed.
Although the study yielded positive findings, it had limitations due to the small sample size and no placebo group. The study also did not have diversity in race or gender. Consequently, the results could drastically change with these factors in place. Since the results of this study are not conclusive, more tests should be conducted before confirming the therapeutic potential of psilocybin on eating disorders like anorexia nervosa.
Further research will be needed to find the adequate dose for this form of therapy and determine how many sessions are required for optimal results. Nonetheless, this promising discovery is a major step in finally having a safe and effective option for the treatment of anorexia nervosa.
The results of the study have been posted on Clinicaltrials.gov and publicized in the Eating Disorder Treatment & Research Center at the University of California, San Diego (UCSD).