Title: Psilocybin therapy for females with anorexia nervosa: a phase 1, open-label feasibility study
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Summary

A small pilot study explored whether psilocybin, the active ingredient in "magic mushrooms," could help women with anorexia nervosa (AN), including those in partial remission (pAN). Ten women participated and received a single dose of psilocybin in a supportive, therapeutic setting. The treatment was safe, with no serious side effects. Many participants found the experience meaningful, and some showed improvements in their relationship with food and body image. This study highlights psilocybin’s potential to support both individuals actively struggling with AN and those in partial remission who continue to face mental and emotional challenges.

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What was the goal?

The study aimed to test whether psilocybin therapy could safely help women with AN improve their mental and emotional relationship with food and body image. It sought to address the psychological struggles tied to the illness, such as rigid thinking, obsessive behaviors, and intense fears about food and weight, which often persist even for individuals in partial remission.

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Why psilocybin?

• Anorexia nervosa is one of the hardest mental illnesses to treat, with high relapse rates and limited success using existing therapies. There are no FDA-approved medications specifically for AN.
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• Psilocybin affects serotonin, a brain chemical often linked to anxiety and rigid thinking in AN. By promoting emotional openness and flexibility, psilocybin may help people reframe their thoughts and move beyond the rigid patterns that keep them stuck.

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Why include women in partial remission?

• What is partial remission? Partial remission means a person with AN has made progress in areas like weight restoration but continues to struggle with entrenched psychological symptoms like fear of gaining weight, rigid control over eating, or obsessive thoughts about body image.
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• Why it matters: Many people in partial remission are overlooked because they no longer meet the strict criteria for AN. However, they often still experience severe mental distress and are at risk of relapse.
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• Focus of this study: Researchers wanted to explore how psilocybin could help this group by addressing lingering psychological symptoms that often resist conventional treatment. This could make partial recovery more stable and prevent long-term relapse.

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What happened in the study?

• Participants: Ten women aged 18 to 40 with either AN or pAN participated in the study.
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• The Treatment: Each received a single 25 mg dose of synthetic psilocybin in a safe, controlled environment with therapists present to guide them before, during, and after the session.

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Key Takeaways

1. Safety
   • The therapy caused no serious side effects. Mild issues like headaches and fatigue were common but temporary.
   • Two participants experienced low blood sugar after treatment, likely linked to their nutritional status rather than the psilocybin itself. This resolved within a day.
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2. Improvements
   • Many participants reported a shift in their mental and emotional well-being, including feeling less preoccupied with weight and body image.
   • Some described a sense of emotional release and greater mental flexibility, which helped them focus on other areas of life.
   • Four participants showed significant improvements in symptoms, with their eating disorder concerns decreasing to levels comparable to the general population.
   • While the results varied, the study highlighted psilocybin’s potential to target the entrenched mental patterns associated with AN.
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3. Experience
   • Most participants described the session as one of the most meaningful experiences of their lives, helping them reevaluate their values and goals.
   • Many reported feeling more open to change and more optimistic about recovery, though most felt additional sessions could enhance the benefits.

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How did participants feel after the experience?

Why is this important?

Partial remission is often a plateau in treatment, where physical recovery doesn't align with mental and emotional healing. This study highlights psilocybin’s potential to address this gap by targeting the psychological roots of AN. It offers hope for stabilizing partial recovery and turning it into full recovery, reducing the risk of relapse. The fact that almost all participants (90%) wished they had more dosing sessions suggests that a multi-dose approach might be more suitable for hard to treat populations like this one. 

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Read Next: Psilocybin Therapy for Obsessive-Compulsive Disorder (OCD)