Novel ketamine and zinc treatment for anorexia nervosa and the potential beneficial interactions with the gut microbiome

Rosiel Elwyn; Jules Mitchell; Michael R Kohn; Christina Driver; Phillipa Hay; Jim Lagopoulos; Daniel Hermens

doi:10.1016/j.neubiorev.2023.105122

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Novel ketamine and zinc treatment for anorexia nervosa and the potential beneficial interactions with the gut microbiome

Journal article

Peer reviewed

Novel ketamine and zinc treatment for anorexia nervosa and the potential beneficial interactions with the gut microbiome

Rosiel Elwyn, Jules Mitchell, Michael R Kohn, Christina Driver, Phillipa Hay, Jim Lagopoulos and Daniel Hermens

Neuroscience & Biobehavioral Reviews, Vol.148, pp.1-37

2023

DOI: https://doi.org/10.1016/j.neubiorev.2023.105122

PMID: 36907256

Appears in Thompson Institute Research Collection

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Abstract

Behavioural neuroscience

Clinical psychology

anorexia nervosa

severe-enduring anorexia nervosa

eating disorders

Gut microbiome

Trauma

PTSD

Interoception

glutamate

GABA

leptin

Stress

Suicide

neurobiology

model

Ketamine

zinc

novel treatment

medication

pharmacology

innovative

co-design

lived experience

neurotransmitter

chronic stress

psychedelics

Ketamine

Thompson Institute Special Collection

UniSC Diversity Area - Disability and Inclusion

Anorexia nervosa (AN) is a severe illness with diverse aetiological and maintaining contributors including neurobiological, metabolic, psychological, and social determining factors. In addition to nutritional recovery, multiple psychological and pharmacological therapies and brain-based stimulations have been explored; however, existing treatments have limited efficacy. This paper outlines a neurobiological model of glutamatergic and γ-aminobutyric acid (GABA)-ergic dysfunction, exacerbated by chronic gut microbiome dysbiosis and zinc depletion at a brain and gut level. The gut microbiome is established early in development, and early exposure to stress and adversity contribute to gut microbial disturbance in AN, early dysregulation to glutamatergic and GABAergic networks, interoceptive impairment, and inhibited caloric harvest from food (e.g., zinc malabsorption, competition for zinc ions between gut bacteria and host). Zinc is a key part of glutamatergic and GABAergic networks, and also affects leptin and gut microbial function; systems dysregulated in AN. Low doses of ketamine in conjunction with zinc, could provide an efficacious combination to act on NMDA receptors and normalise glutamatergic, GABAergic and gut function in AN.

Details

Title: Novel ketamine and zinc treatment for anorexia nervosa and the potential beneficial interactions with the gut microbiome
Authors: Rosiel Elwyn (Corresponding Author) - University of the Sunshine Coast, Queensland, Thompson Institute
Jules Mitchell (Author) - University of the Sunshine Coast, Queensland, Thompson Institute
Michael R Kohn (Author) - Westmead Hospital
Christina Driver (Author) - University of the Sunshine Coast, Queensland, Thompson Institute
Phillipa Hay (Author) - Western Sydney University
Jim Lagopoulos (Author) - University of the Sunshine Coast, Queensland, Thompson Institute
Daniel Hermens (Author) - University of the Sunshine Coast, Queensland, Thompson Institute
Publication details: Neuroscience & Biobehavioral Reviews, Vol.148, pp.1-37
Publisher: Elsevier Ltd.
Date published: 2023
DOI: 10.1016/j.neubiorev.2023.105122
ISSN: 1873-7528
PMID: 36907256
Organisation Unit: School of Health - Biomedicine; School of Health - Nursing; Thompson Institute; School of Law and Society
Language: English
Record Identifier: 99710198902621
Output Type: Journal article

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Collaboration types: Domestic collaboration
Web Of Science research areas: Behavioral Sciences; Neurosciences

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