Dr. Salah El Mestikawy

By Joel Ceausu
The Suburban

McGill University announced that a McGill-led research team working with a French Sorbonne-led team (CNRS, INSERM and Sorbonne university) “believes it has identified the neurological mechanism underlying anorexia nervosa as well as a possible cure.”

The team’s findings, published in Nature Communications, “have the potential to improve the lives of millions of people around the world, mostly women, who suffer from the common eating disorder, which has the highest mortality rate of any psychiatric disease.

“Working with mice, researchers discovered that a deficit in a neurotransmitter in an area of the brain associated with the reward system, can lead to excessive habit formation and precipitate the compulsive self-starvation seen in people who suffer from anorexia nervosa.”

McGill Psychiatry professor Dr. Salah El Mestikawy, the senior author on the paper and researcher at the Douglas Research Centre, “looked at whether using a medication known to increase the presence of the neurotransmitter in the brain could have an effect on these compulsive self-destructive behaviours.”

“We found that it fully reversed the anorexia-like behaviour in mice, and we believe that it could potentially offer the first mechanism-based treatment of anorexia nervosa. In fact, we are already seeing its effects on some patients with the disease.”

As well, “ongoing independent studies in Toronto and Montreal led by an independent psychiatrist Dr. Leora Pinhas are showing positive results for 10 patients with severe anorexia nervosa who are being treated with low doses of the drug, donepezil. Three patients are in full remission and the other seven show a marked improvement. Further double-blind clinical trials, comparing results of those taking a placebo with those taking the medication, are due to take place this year at Columbia University, Denver University, and the Hôpital Sainte-Anne in Paris.

Mestikawy says, however, that “between clinical trials and government approval, it may take several years before a new drug can be used to treat anorexic patients, and there may be possible effects on other diseases involving compulsive behaviours. The McGill researchers are working with the French team to develop a novel compound with fewer problems. “We also suspect that other compulsive pathologies such as obsessive-compulsive disorders (OCD) and addictions can also be improved by donepezil, so we are actively looking for collaboration with other psychiatrist around the world to explore the possibilities.”