MDMA Trial for Anorexia Nervosa
The CPRG is also designing a Phase 2 trial of MDMA-assisted Internal Family Systems (IFS) therapy for young adults with anorexia nervosa, which carries the highest mortality rate of any psychiatric disorder.
The proposed study brings together Cambridge, Imperial College London and Inner Space Research in Utah. The collaboration emerged after the group’s inaugural Cambridge Psychedelic Research Day, where CPRG members connected with neuroscientist and psychiatrist Dr David Erritzøe at Imperial, whose team recently completed a psilocybin trial for anorexia.
“When I spoke with David at the conference, he mentioned that a few colleagues in Imperial’s Division of Psychiatry––namely Prof Dasha Nicholls and Dr Victoria Burmester––were interested in the potential of MDMA as a treatment for this population,” said Anya Ragnhildstveit, a PhD candidate at Cambridge and CPRG member.
According to the team, the trial is being developed through cross-site collaboration, alongside a wider network of experts in psychedelic therapy, IFS and eating disorders, including Prof David Nutt, Dr Reid Robison and Prof Camilla Lindvall Dahlgren.
A notable feature of the proposed study is its psychotherapeutic model. Developed by Dr Richard Schwartz, IFS is a trauma-informed, non-pathologising approach that conceptualises the mind as containing different “parts” with distinct roles and protective functions. The model has gained traction among psychedelic therapists in real-world settings, although formal clinical evidence remains limited.
“While the evidence base for IFS is not as strong as it is for other, more established psychotherapies, many patients with eating disorders do not sufficiently benefit from existing treatments,” Ragnhildstveit said. “We’re even seeing shifts toward palliative care and assisted dying for people who have exhausted all available options. It’s time for a radically innovative, patient-driven approach to care.”
The rationale for pairing MDMA with IFS is that this combination may be especially well suited to the internal conflict, self-criticism and protective adaptations related to food, control and identity that often characterise anorexia. In this context, MDMA may help reduce fear and defensiveness, potentially creating a therapeutic window for deeper psychological work.
“Our vision is to help young adults with anorexia become their own healers by helping them build an inner therapeutic approach they can rely on long after treatment ends,” Ragnhildstveit said. “We want to support a model of recovery that helps people reclaim agency rather than handing it over to medications, therapists or caregivers.”
Ragnhildstveit’s PhD research broadly examines mental health treatments and service pathways for young people with eating disorders, particularly the transition from child to adult NHS services. This work sits within a wider context of rising eating disorder burden worldwide.
A recent study from her group at Cambridge found that 1 in 20 children and young people meet criteria for an eating disorder—a global prevalence substantially higher than previously estimated. The COVID-19 pandemic likely contributed to this increased burden, with eating disorder-related A&E attendances among young people nearly tripling in the first year of the pandemic.
“To this day, there hasn’t been a single approved medication for anorexia,” Ragnhildstveit said. “With historically poor treatment response, high relapse rates, rising prevalence and hospital admissions, and inadequate resources to meet growing demand, we can no longer ignore this issue.”
Such urgency has fuelled growing interest in novel interventions that not only address eating disorder symptoms, but also the deeper psychological and relational dynamics of the illness. For the team behind the MDMA trial, the goal is to evaluate a new treatment model while expanding the evidence base for a population long underserved by psychiatric research, Ragnhildstveit said.