Anorexia has phenomenological parallels to anxiety and addiction, both of which have been shown to improve with psilocybin-assisted interventions.

Scientists at the Psychedelic Research Unit of Johns Hopkins are starting a clinical trial pilot study to evaluate the effects of psilocybin-assisted psychotherapy (PcbAP) for treating anorexia nervosa (AN). This study demonstrates the increasing interest in researching the therapeutic applications of psychedelic drugs. The AN clinical trial comes on the heels of the US Food and Drug Administration (FDA) granting breakthrough therapy designation for the PcbAP trial for treatment-resistant depression that is currently underway.

Anorexia nervosa is an eating disorder primarily affecting women. The condition causes people to obsess about food and their weight. Sufferers usually have a distorted body image, seeing themselves as overweight even though they are often significantly underweight. Complications of AN include heart problems, electrolyte imbalance, bone loss, anemia, and death.

Dr. Natalie Gukasyan, a post-doctoral research fellow at Johns Hopkins, told New Atlas:

Our goal is to determine whether psilocybin can be safely administered in a supportive setting to people with anorexia nervosa (AN), and whether this intervention can produce improvements in mood, quality of life, and cognitive and behavioral symptoms of the disorder.

Many aspects of AN are not fully understood. However, Dr. Gukasyan explains the factors that indicate PcbAP may be effective for treating AN:

The pathophysiology of AN remains obscure but some evidence suggests that the serotonin 2A (5-HT2A) receptor system may be involved. The action of psilocin, the active metabolite of psilocybin, is mediated by stimulation of these receptors. AN also shares phenomenological parallels to anxiety and addiction, both of which have been shown to improve with PcbAP interventions.

According to ClinicalTrials.gov, the pilot study will test about 18 participants and conclude in December 2022. As of August 12, 2019, the study was in the very early stages and not yet recruiting volunteers.

The Future of PcbAP

Psychedelic drugs such as psilocybin that are found in psychedelic mushrooms (aka magic mushrooms) are clearly poised to change the face of treatment for several mental conditions. However, it is important to remember that psilocybin is only part of the story when it comes to the effects (beneficial or otherwise) of naturally-occurring compounds. Magic mushrooms, for example, contain a cocktail of compounds along with psilocybin including psilocin, baeocystin, norbaeocystin, norpsilocin, and aeruginascin. There are no studies examining how all these compounds work together in the human body to create the overall psychedelic experience (known in medical cannabis research as the entourage effect).

There is no question that PcbAP is showing great promise. But the question remains, how much better could therapy be if scientists understood the pharmacology of all the magic mushroom compounds and how they work together? Formulating accurate and precise doses of each component allows the development of targeted therapies that may be more effective and have fewer side effects. Further, healthcare providers could provide better treatments for women that take into account their unique pre- and post-menopausal physiology. There is a significant and critical unmet need for understanding the chemical variability in natural compounds like psilocybin mushrooms.