Eating disorders are serious illnesses with high mortality and comorbidity. Psychedelic-assisted therapy shows promise for common comorbidities like mood disorders, PTSD, and substance use disorders, and may also benefit eating disorders themselves. This review summarizes preliminary data on ketamine, MDMA, psilocybin, and ayahuasca for anorexia nervosa, bulimia nervosa, and binge eating disorder. Preliminary evidence suggests psychedelic-assisted therapy may be effective for anorexia and bulimia, with very little data on binge eating disorder. Potential mechanisms include improving body image beliefs, normalizing reward processing, promoting cognitive flexibility, and facilitating trauma processing, alongside general therapeutic factors. Safety concerns and future research recommendations are discussed.
Chronic MDMA users show increased fractional anisotropy in white matter tracts, particularly the corpus callosum and corticospinal tracts, with some links to usage intensity. However, blood neurofilament light chain levels did not differ from controls. The absence of reduced fractional anisotropy and elevated NfL—typically seen in conditions with white matter lesions, such as stimulant and ketamine use disorders—suggests MDMA use is not associated with significant white matter damage. Thus, axonal degradation observed in animal models was not replicated in this human sample of 39 chronic users and 39 matched controls.
Chronic methamphetamine users show diminished cognitive and emotional empathy toward positive stimuli, elevated punitive social behavior regardless of provocation, and heightened self-reported trait anger compared to non-users. Chronic MDMA users differ from controls only by displaying increased punitive behavior when provoked. Higher hair concentrations of both drugs may be linked to reduced cognitive empathy, and greater lifetime MDMA use correlates with more punitive behavior among MDMA users. The dopaminergic mechanism of methamphetamine may underlie social-cognitive deficits.
A single 100 µg dose of lysergic acid diethylamide (LSD) improved offline motor learning the next day and, one week later, reduced perceived stress and increased aspects of cognitive flexibility in 45 healthy adults. Electroencephalography showed that LSD acutely decreased N1 and P2 auditory event-related potential amplitudes, with P2 still modulated after one week. Transcranial magnetic stimulation revealed increased motor-evoked potential amplitude and faster latency under LSD. Brain-derived neurotrophic factor levels were unchanged. The findings suggest lasting effects of LSD on learning and neural signals, while highlighting challenges in measuring long-term potentiation in humans.