Ketamine Therapy Research in Severe and Enduring Anorexia Nervosa
Yes, ketamine therapy is being actively studied as a novel treatment approach for severe and enduring anorexia nervosa, with emerging evidence suggesting potential benefits for this difficult-to-treat population.
Current Research Status
Ketamine research in anorexia nervosa is still in early stages, primarily consisting of:
- Case reports and small case series
- Exploratory open-label trials
- Theoretical mechanism studies
Key Findings from Recent Studies
A 2022 pilot study combined a ketogenic diet with ketamine infusions in weight-recovered anorexia patients with persistent eating disorder psychopathology. The treatment showed significant improvements in eating disorder symptoms, including shape and weight concerns, with most participants maintaining stable weight 1.
A 2025 exploratory case series of eight female patients with anorexia spectrum disorders found that Ketamine Adjuvant Treatment (KAT) significantly improved BMI with a coefficient of 0.71 (p=0.002), with improvement trends appearing after the fourth or fifth infusion 2.
A notable 2020 case report documented complete remission in a 29-year-old woman with 15 years of severe and enduring anorexia nervosa following ketogenic diet and ketamine infusions, with remission persisting beyond 6 months 3.
Proposed Mechanisms of Action
Ketamine's potential benefits in anorexia nervosa may work through several mechanisms:
Neuroplasticity enhancement: Ketamine increases glutamate transmission, potentially improving neuroplasticity and neurogenesis that may be impaired in anorexia nervosa 4.
Targeting cognitive rigidity: Ketamine may help remodel rigid food-centered thoughts and obsessive-compulsive-like symptoms that are characteristic of anorexia nervosa 2.
Rapid antidepressant effects: Given the high comorbidity of depression in anorexia nervosa and the ineffectiveness of traditional antidepressants in underweight patients, ketamine's rapid antidepressant properties may be particularly beneficial 4.
Addressing neurocognitive biases: Ketamine may target neurocognitive biases that are difficult to address with conventional treatments 2.
Current Limitations and Research Gaps
- Most studies are limited to case reports and small case series without control groups
- Research has primarily focused on anorexia nervosa rather than other eating disorders
- Optimal dosing protocols have not been established
- Long-term safety and efficacy data are lacking
- Specific patient selection criteria need development
Future Research Directions
The current evidence suggests several important avenues for future research:
- Controlled trials with larger sample sizes
- Studies examining ketamine efficacy across different eating disorder subtypes
- Establishment of safety profiles and optimal dosing regimens
- Development of individualized treatment approaches
- Investigation of potential synergistic effects when combined with other treatments
Clinical Implications
While promising, ketamine therapy for anorexia nervosa should currently be considered experimental. The 2022 review by Brain Sciences notes that ketamine shows "transdiagnostic potential for EDs, particularly among clinical nonresponders" 5, suggesting it may be most appropriate for treatment-resistant cases.
The field of technology-based psychological interventions for eating disorders is also evolving rapidly, which may complement pharmacological approaches like ketamine in the future 6.