Dronabinol in severe, enduring anorexia nervosa: a randomized controlled trial

Area of Science:

• Psychiatry
• Pharmacology
• Clinical Nutrition

Background:

• Severe, longstanding anorexia nervosa (AN) has limited pharmacological treatment options.
• Previous controlled studies have investigated a narrow range of drugs for AN.

Purpose of the Study:

• To assess the efficacy of dronabinol, a synthetic cannabinoid agonist, in improving body weight.
• To evaluate the impact of dronabinol on psychopathological personality traits related to eating disorders in women with severe AN.

Main Methods:

• A prospective, randomized, double-blind, placebo-controlled crossover study was conducted.
• Twenty-five women with AN (duration ≥ 5 years) received dronabinol (2.5 mg twice daily) or placebo for 4 weeks each, separated by a 4-week washout.
• Primary outcome was mean change in body weight; secondary outcome was changes in Eating Disorder Inventory-2 (EDI-2) scores.

Main Results:

• Dronabinol treatment resulted in a significant weight gain of 0.73 kg compared to placebo (p < 0.01).
• Dronabinol predicted weight gain, considering EDI-2 body dissatisfaction and leptin levels.
• No significant changes were observed in EDI-2 subscale scores over time.

Conclusions:

• Dronabinol therapy was well-tolerated in women with severe AN.
• Four weeks of dronabinol treatment induced a small but significant weight gain without severe adverse events.