A five-month follow-up revealed sustained symptom remission in a patient with anorexia nervosa after structured .
The patient experienced significant reductions in eating disorder symptoms and comorbid depression and anxiety throughout the treatment.
Symptom improvement was marked from baseline to the fourth ketamine-assisted psychotherapy session.
A temporary increase in symptoms occurred during the period without therapy, followed by a decline during ketamine booster treatments.
No new side effects or worsening symptoms were reported, indicating that ketamine was well-tolerated.
This case represents the first documented instance of structured ketamine-assisted psychotherapy for anorexia nervosa in Europe.
Simplified
INTRODUCTION: Ketamine, an N-methyl-D-aspartate receptor antagonist, has demonstrated rapid antidepressant effects at sub-anesthetic doses, making it a promising candidate for treatment-resistant mood disorders, anxiety, post-traumatic stress disorder, suicidality, and recently, eating disorders (EDs). However, its effects are transient, and (KAP) has emerged as a method to extend therapeutic benefits by combining ketamine's heightened neuroplasticity with psychotherapy. Emerging evidence suggests KAP can reduce ED psychopathology and alleviate comorbid symptoms of depression and anxiety, potentially improving patients' engagement in psychotherapy and enhancing treatment outcomes.
CASE PRESENTATION: This study presents a 5-month follow-up of a female patient in her late twenties who underwent a structured treatment protocol consisting of four KAP sessions delivered within an Acceptance and Commitment (ACT) framework, plus three ketamine booster treatments. At intake, the patient presented with a diagnosis of anorexia nervosa (AN) and comorbid depression, reporting persistent intrusive thoughts about food and body image, dissatisfaction with prior treatments, and only partial relief from antidepressants. The patient sought ketamine treatment to improve energy levels, emotional flexibility, and overall quality of life. Assessments, including medical evaluations and self-reported measures of eating disorder pathology, depression, anxiety, suicidal ideation, quality of life, psychological flexibility, and ketamine-related side effects, were conducted at five time points both before and after the intervention. The primary aim was to investigate potential changes in ED psychopathology and comorbid symptoms follwoing treatment.
CONCLUSION: To our knowledge, this is the first documented case of structured KAP for AN showing both rapid and sustained symptom remission five months post-treatment, as well as the first European study to comprehensively investigate outcomes associated with KAP in EDs. Changes observed across most assessments indicated a consistent pattern: marked symptom reduction from baseline through the fourth KAP session, followed by a temporary symptom increase during the therapy-free interval between the final KAP session and the first ketamine booster dose. Symptoms then declined during the booster phase, with stabilization or further improvement at five-month follow-up. Ketamine was well-tolerated, with no increase in side effects or emergence of new symptoms. While preliminary findings are promising, important knowledge gaps remain. These include ketamine's applicability across ED subtypes, severity levels, and age groups, as well as optimal treatment and assessment protocols that support long-term therapeutic effects and prevent relapse.
Key numbers
4.84 to 0.91
Global Score Decrease
global scores at baseline and five-month follow-up
15 to 5
Score Decrease
scores at baseline and five-month follow-up
29 to 20
AAQ-II Score Decrease
AAQ-II scores at baseline and five-month follow-up
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Declarations. Ethics approval and consent to participate: Written informed consent was obtained from the patient, who agreed to share her data for the current case report. The patient was informed that she was free to contact the clinic’s medical director or the clinical psychologist who had treated her at any point in time during the publication process, or after the article is published, should she have any questions or concerns regarding her participation. The Regional Committees for Medical and Health Research Ethics (REK) South-East (reference ID 806316) and Sikt -the Norwegian Agency for Shared Services in Education and Research (reference ID 665591) approved the study. Consent for publication: The patient was informed that she could withdraw her consent at any time leading up to the publication of the article, but not after the article had been published online. Competing interests: The authors declare no competing interests.
