Can Psilocybin Help Young People Overcome Severe Anorexia?

In an effort to confront one of psychiatry’s deadliest and most treatment-resistant illnesses, researchers have outlined a pioneering clinical trial to test whether psychedelic-assisted therapy can help young patients break free from severe anorexia. The study protocol, published in the journal PLoS ONE, details an upcoming trial designed to evaluate the safety, tolerability, and potential benefits of psilocybin when combined with psychotherapy in adolescents and young adults who have relapsed following standard medical care.

Targeting Cognitive Rigidity in Anorexia

Anorexia nervosa commonly emerges during adolescence and carries among the highest mortality and relapse rates of any psychiatric disorder. While specialized psychological treatments and nutritional rehabilitation represent the standard of care, many individuals experience recurring relapses and chronic illness, highlighting an urgent need for innovative interventions.

Clinicians have long recognized that the disorder is characterized by profound cognitive rigidity—an unyielding mental inflexibility that drives obsessive concerns about food, weight, and body image. In recent years, psilocybin, a psychoactive compound found in certain mushrooms, has demonstrated an ability to disrupt entrenched, rigid thought patterns in other treatment-resistant conditions. According to the study authors, led by David K. Sjöström, administering psilocybin in a supportive therapeutic environment may help loosen these rigid neurobehavioral loops and create an opening for sustained psychological recovery.

How the Clinical Trial Is Structured

The proposed investigation, designated the psiAN study, is a phase IIa randomized controlled trial that will recruit participants aged 16 to 35 who meet the clinical criteria for anorexia nervosa and have a documented history of relapse.

Under the trial framework, participants will be randomly allocated to one of two arms. One group will receive two separate 25-milligram doses of psilocybin accompanied by manualized psychological support, administered alongside their treatment as usual. The control group will continue receiving treatment as usual alone, allowing investigators to isolate the specific effects of the psychedelic-assisted intervention against standard clinical practice.

Measuring Safety, Recovery, and the Brain

Because patients recovering from severe anorexia often present with physical vulnerabilities, the trial’s primary endpoint focuses on safety and tolerability. Investigators will closely track adverse events, medical parameters, and psychiatric measures from the first administration through the primary evaluation point.

Secondary outcomes will assess changes in eating disorder symptom severity, relapse rates, mood, general well-being, and personality traits over a 12-month follow-up period. To clarify how the intervention affects the brain, researchers will also use functional magnetic resonance imaging (fMRI) and analyze peripheral biomarkers such as brain-derived neurotrophic factor. The imaging scans will examine changes in neural connectivity and reward processing while participants complete tasks assessing responses to monetary incentives and calorie-related visual cues.

A Cautious Step for Adolescent Psychedelic Medicine

While psychedelic research has rapidly expanded over the past decade, studies have rarely included minors. To address safety concerns, the psiAN protocol incorporates a cautious, staged enrollment design: participants aged 16 and 17 will only be recruited after an independent safety monitoring board evaluates the data gathered from the adult cohort (aged 18 to 35) and confirms adequate safety and tolerability.

The authors note that the published paper outlines a rigorous clinical roadmap rather than completed findings. Nonetheless, establishing this detailed protocol represents a major step forward, laying the groundwork for careful, evidence-based exploration of psychedelic therapy in younger individuals battling life-threatening psychiatric illness.

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