716. A randomised-controlled feasibility study of ketamine for the treatment of depression with anorexia nervosa
Johanna Keeler, Hubertus Himmerich, Janet Treasure, Y Benbow, K Rowlands, J Law, R Morris, A Young, Mitul A. Mehta, Mario F Juruena, B Carter, Carol Kan, Vanessa Lawrence
International Journal of Neuropsychopharmacology September 9, 2026 DOI: 10.1093/ijnp/pyag040.488 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomised, double-blinded, single-centre, placebo-controlled feasibility study Randomized Peer reviewed |
|---|---|
| Sample size | 60 |
| Population | Adults aged 18 years or older with anorexia nervosa of at least 3 years' duration and depression that has not responded to one or more treatments |
| Interventions | Oral ketamine placebo |
| Dose | 60-180mg |
| Duration | Twice per week for four weeks (8 dosing visits), with follow-up at 28 days, 3 months and 6 months post-randomisation |
| Topics | Depression Esketamine Ketamine |
| Key points | The authors propose that oral ketamine may be effective for depression in people with anorexia nervosa, since standard antidepressants show little efficacy in this group, and that a feasibility study is needed before an adequately powered Phase II randomised controlled trial. The study's primary aim is to assess feasibility through recruitment, assessment response and drop-out rates, with secondary aims covering acceptability, safety, tolerability and changes in depression, eating disorder symptoms and quality of life. |
Abstract
Abstract Background Approximately a third of people with anorexia nervosa (AN) develop a severe and enduring form of the illness, which is often accompanied by depression. This can be a key barrier to recovery. Anti-depressant medications are less effective in treating depression in patients with acute AN, thus new pharmacological treatment options are needed. Ketamine is currently used for treatment-resistant depression in the UK and may be effective in patients with both AN and depression. Aims & Objectives The primary objective of the EDEN study is to investigate the feasibility of using oral ketamine in this population, as indicated by participant recruitment, assessment response rate and drop-out rate. Secondary objectives include acceptability of the intervention, changes in key outcomes (depression, eating disorder symptoms, and quality of life) at 28 days, 3- and 6-months post-randomisation, and to collect data on the safety and tolerability of oral ketamine in this population.
Method: The EDEN study is a randomised, double-blinded (participant, researchers, assessors and analyst), single-centre, placebo-controlled feasibility study of 60 adults (≥18 years old) with a diagnosis of depression that has not responded to one or more treatments and AN with a duration of ≥3 years. Participants will be randomised (1:1) to receive oral ketamine 60-180mg, or placebo, twice per week for four weeks. Study participation consists of three phases; (i) Pre-dose Assessments (Screening and Baseline), (ii) Dosing period (8 dosing visits, twice weekly for 4 weeks), and (iii) Follow-up (at 28 days end of intervention, 3- and 6-months post-randomisation).
Results: Recruitment for the study commenced in August 2025. Quantitative feasibility results of the study will be available in 2028. However, individual experiences of participants in the study so far will be presented. Discussion & Conclusions Treating depressive symptoms in individuals with AN currently remains a clinical challenge, given that typical anti-depressants show little efficacy in this population. An adequately powered Phase II RCT comparing low-dose oral ketamine with a placebo is needed to definitively determine its effectiveness and safety in treating depression in people with AN. Given that there are challenges in recruiting and retaining this patient group for treatment RCTs, particularly where a pharmacological intervention may be involved, we hope that the results from this feasibility study will inform the development of a successful RCT protocol.