Psilocybin as a Treatment for Anorexia Nervosa: A Pilot Study

Brief Summary

The primary aim of this study is to assess the acceptability and efficacy of treating anorexia nervosa with psilocybin. The secondary aim of this study is to use Magnetic Resonance Imaging (MRI) and Electroencephalography (EEG) to examine the neuronal underpinnings of treatment with psilocybin in this patient group.

Intervention / Treatment

  • Psilocybin (DRUG)
    Psilocybin assisted psychotherapy

Condition or Disease

  • Anorexia Nervosa

Phase

  • Phase 1
  • Phase 2
  • Study Design

    Study type: INTERVENTIONAL
    Status: Active, not recruiting
    Study results: No Results Available
    Age: 21 Years to 65 Years
    Enrollment: 21 (ACTUAL)
    Funded by: Other
    Allocation: N/A
    Primary Purpose: Treatment

    Masking

    All participants will receive 3 doses of psilocybin. The maximum dose a participant will receive in a single session is 25 mg.

    Clinical Trial Dates

    Start date: May 28, 2021 ACTUAL
    Primary Completion: Jun 01, 2023 ESTIMATED
    Completion Date: Jun 01, 2024 ESTIMATED
    Study First Posted: Aug 10, 2020 ACTUAL
    Results First Posted: Aug 30, 2020
    Last Updated: Apr 28, 2023

    Sponsors / Collaborators

    Lead Sponsor: Imperial College London
    Lead sponsor is responsible party
    Responsible Party: N/A

    Anorexia nervosa is the most fatal of all psychiatric conditions. With the current paucity of effective pharmacological and psychological treatments, and fewer than half of those diagnosed making a full recovery, there is a great need for new treatment avenues to be explored. For this study, we will recruit patients who have a primary diagnosis of anorexia nervosa as defined by DSM-V criteria, which has been established by their specialist ED team to have been present for at least 3 years, and who have found other forms of treatment ineffective. Over a period of 6 weeks, participants who are deemed eligible at screening will partake in 8 study visits, including three psilocybin dosing sessions with varying doses. The maximum dose of psilocybin a participant will receive in a single session is 25 mg. Across these 8 visits, there will also be 2 MRI scans, up to 5 EEG recordings and a range of psychological measures (questionnaires and interviews). There will be a follow-up period of 12 months following the final study visit.

    Participant Groups

    • Psilocybin

    Eligibility Criteria

    Sex: Female
    Minimum Age: 21
    Maximum Age: 65
    Age Groups: Adult / Older Adult
    Healthy Volunteers: Yes

    Inclusion Criteria:

    1. Primary DSM-V diagnosis of Anorexia Nervosa
    2. Current diagnosis of Anorexia Nervosa, established by specialist eating disorder care team to have likely been present for \>3 years
    3. Current or past treatments have not been successful to maintain remission from anorexia
    4. Be in the care of a GP and specialist eating disorder team in the UK
    5. Have a GP and specialist eating disorder team in the UK who can confirm diagnosis
    6. Sufficiently competent in English and mental capacity to provide written informed consent
    7. BMI ≥14kg/m2 and medically stable
    8. Capacity to consent
    9. Agree to have us maintain contact with an identified next-of-kin for the duration of the study
    10. Agree to have us maintain contact with GP and/or specialist eating disorder team as required, for the duration of the study

    Exclusion Criteria:

    1. Current or previously diagnosed psychotic disorder
    2. Immediate family member with a diagnosed psychotic disorder
    3. Unstable physical condition e.g., rapid weight loss \> 2kg in the prior month
    4. Abnormal serum electrolytes, raised cardiac enzymes, hepatic or renal dysfunction
    5. MRI or EEG contraindications
    6. A history of laxative abuse in the last 3 months (more than twice a week for 3 months)
    7. History of serious suicide attempts or presence of a suicide/ serious self-harm risk at screening
    8. Currently an involuntary patient
    9. Emotionally unstable personality, history of mania, or other psychiatric problem that the screening clinician feels may jeopardise the therapeutic alliance and/or safe exposure to psilocybin
    10. Blood or needle phobia
    11. Positive pregnancy test at screening or during the study, or woman who are breastfeeding
    12. If sexually active, participants who lack appropriate contraceptive measures
    13. Drug or alcohol dependence within the last 6 months
    14. No email access
    15. Patients presenting with abnormal QT interval prolongation at screening or with a history of this (QTc at screening above 470ms)
    16. Patients who are currently, or have recently (within 3 months) been enrolled in another CTIMP.

    Primary Outcomes
    • Increase in readiness and motivation to recover from baseline to primary endpoint, which will be related to long-term improvements in psychopathology.

    • Decrease in eating disorder psychopathology.

    • Decrease in eating disorder psychopathology.

    Secondary Outcomes
    • Changes in blood oxygen level dependent (BOLD) signal during rest and disorder relevant tasks.

    More Details

    NCT Number: NCT04505189
    Other IDs: 19HH5267
    Study URL: https://clinicaltrials.gov/study/NCT04505189
    Last updated: Sep 29, 2023