Brain Sci: Ketamine Therapy for Eating Disorders

Prevalence and Impact:

• EDs are "highly prevalent, disabling, and potentially fatal psychiatric illnesses."
• Approximately 8–15% of children and adolescents and 16% of adults are affected by EDs.
• Lifetime prevalence nervosa (AN): 1.6% (1.4% women, 0.2% men) Bulimia nervosa (BN): 2.5% (1.9% women, 0.6% men) Binge eating disorder (BED): 3.8% (2.8% women, 1.0% men) Eating disorder not otherwise specified (EDNOS): 7.9% (4.3% women, 3.6% men)
• The socioeconomic burden of EDs in the U.S. is estimated at USD 64.7 billion annually, equating to USD 11,808 per individual diagnosed.
• Nonfinancial reduction in personal well-being is further valued at USD 326.5 billion.
• AN has the highest mortality rate among EDs, with a standardized mortality ratio (SMR) of 5.9–10.5.
• AN carries a 12-fold increased risk of death, higher than any other psychological condition.
• Long term studies show that after 10-20 years follow up, 64% of AN patients, 53% of BN patients, and 30% of BED patients still met full diagnostic criteria for an ED.
• More than 50 years of literature suggests that less than half of ED sufferers achieve full remission.

Ketamine Treatment:

• Ketamine, an N-methyl-D-aspartate receptor (NMDAr) antagonist, is being investigated as a potential treatment for EDs.
• Initial studies, primarily case series and reports focusing on AN, show promising results.
• One study of 15 patients with atypical, chronic refractory AN of 11.3 years average duration, showed marked and sustained remissions in 9 of those patients.
• A case study of a patient with extreme BN, that was purging 40 times a day, resulted in complete cessation of those behaviors after ketamine assisted therapy.
• More research is needed to determine the efficacy and safety of ketamine treatment for EDs.

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