Eating disorders (EDs) are serious, life-threatening psychiatric conditions associated with physical and psychosocial impairment, as well as high morbidity and mortality. Given the chronic refractory nature of EDs and the paucity of evidence-based treatments, there is a pressing need to identify novel approaches for this population. The noncompetitive N-methyl-D-aspartate receptor (NMDAr) antagonist, ketamine, has recently been approved for treatment-resistant depression, exerting rapid and robust antidepressant effects. It is now being investigated for several new indications, including obsessive–compulsive, post-traumatic, and substance use disorder, and shows transdiagnostic potential for EDs, particularly among clinical nonresponders. Hence, the aim of this review is to examine contemporary findings on the treatment of EDs with ketamine, whether used as a primary, adjunctive, or combination psychopharmacotherapy. Avenues for future research are also discussed. Overall, results are encouraging and point to therapeutic value; however, are limited to case series and reports on anorexia nervosa. Further empirical research is thus needed to explore ketamine efficacy across ED subgroups, establish safety profiles and optimize dosing, and develop theory-driven, targeted treatment strategies at the individual patient level.
A key feature of the brain's ability to tell time and generate complex temporal patterns is its capacity to produce similar temporal patterns at different speeds. For example, humans can tie a shoe, type, or play an instrument at different speeds or tempi-a phenomenon referred to as temporal scaling. While it is well established that training improves timing precision and accuracy, it is not known whether expertise improves temporal scaling, and if so, whether it generalizes across skill domains. We quantified temporal scaling and timing precision in musicians and non-musicians as they learned to tap a Morse code sequence. We found that non-musicians improved significantly over the course of days of training at the standard speed. In contrast, musicians exhibited a high level of temporal precision on the first day, which did not improve significantly with training. Although there was no significant difference in performance at the end of training at the standard speed, musicians were significantly better at temporal scaling-i.e., at reproducing the learned Morse code pattern at faster and slower speeds. Interestingly, both musicians and non-musicians exhibited a Weber-speed effect, where temporal precision at the same absolute time was higher when producing patterns at the faster speed. These results are the first to establish that the ability to generate the same motor patterns at different speeds improves with extensive training and generalizes to non-musical domains.
Eating disorders (EDs) are serious, life-threatening psychiatric conditions associated with physical and psychosocial impairments, as well as high morbidity and mortality. Given the chronic refractory nature of EDs and the paucity of evidence-based treatments, there is a pressing need to identify novel approaches for this population. The noncompetitive N-methyl-D-aspartate receptor (NMDAr) antagonist, ketamine, has recently been approved for treatment-resistant depression, which exhibits rapid and robust antidepressant effects, particularly among clinical non-responders. It is now being investigated for several new indications, including obsessive-compulsive, post-traumatic, and substance use disorder; and shows transdiagnostic potential for EDs. As such, the aim of this review is to examine contemporary findings on the treatment of EDs with ketamine, whether used as a primary, adjunctive, or combination pharmacotherapy. Avenues for future research are also discussed. Overall, results are encouraging and point to therapeutic value, yet are limited to case series and reports principally on anorexia nervosa. Further empirical work is thus needed to explore and establish ketamine efficacy for EDs, and to inform targeted treatment strategies.
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