New Study Suggests Treatment for Anorexia

THURSDAY, July 11, 2024 -- A significant breakthrough in the understanding and treatment of anorexia nervosa has been made by a team of researchers, who suggest that a deficiency in a particular brain chemical might be a root cause of the disorder. This discovery has led to the development of a promising potential treatment.

Investigations in mice have shown that a lack of acetylcholine, a neurotransmitter linked with the brain’s reward mechanism, may be associated with the formation of excessive habits. This deficiency is believed to contribute to the compulsive self-starvation behaviors observed in individuals with anorexia, as detailed by researchers in the July 7 issue of Nature Communications.

The study found that donepezil, a drug commonly used for Alzheimer's disease that enhances acetylcholine levels, was able to completely reverse anorexia-like behaviors in mice. This revelation opens the door to what could be the first treatment for anorexia nervosa that directly targets its underlying mechanisms. Dr. Salah El Mestikawy, a professor of psychiatry at McGill University’s Douglas Research Center in Montreal, led the study. He expressed optimism about the drug's potential, noting that even now, some patients are experiencing its benefits.

Early clinical observations have shown positive outcomes in ten patients with severe anorexia who are currently on low doses of donepezil. Out of these, three patients have achieved full remission, while the remaining seven have exhibited significant improvements.

To further validate these findings, full-scale clinical trials are scheduled to commence later this year across three major hospitals in the United States and France. These trials will compare the effects of donepezil to those of a placebo in the treatment of anorexia.

Despite these promising developments, Dr. El Mestikawy cautioned that it may take several years before a new drug specifically targeting anorexia could receive government approval and become widely accessible. One of the challenges is that donepezil can cause several gastrointestinal and muscle-related side effects. Consequently, researchers are endeavoring to create a new medication that can increase acetylcholine levels with fewer adverse effects.

Interestingly, Dr. El Mestikawy also pointed out the potential of donepezil in treating other compulsive disorders, such as obsessive-compulsive disorder (OCD) and addictions. The research team is actively seeking collaborations with psychiatrists worldwide to explore these possibilities further.

In summary, the identification of acetylcholine deficiency as a possible cause of anorexia nervosa has not only enhanced the understanding of the disorder but also led to the development of a potential new treatment. Although challenges remain, including the need for extensive clinical trials and addressing side effects, this research represents a significant step forward in the fight against anorexia nervosa and potentially other compulsive disorders.