ClinicalTrials.gg
Not yet recruitingNCT06518941Updated Oct 23, 2026

An Open Trial of a Novel Pharmacotherapy for Habit Modification in Anorexia Nervosa

A Phase 2 interventional study of Donepezil in Anorexia Nervosa, sponsored by New York State Psychiatric Institute. Not yet recruiting at 1 site in United States. Open to participants aged 18 Years to 60 Years. Per ClinicalTrials.gov, last updated 2026-10-23.

Sponsored by New York State Psychiatric Institute · Phase 2, Interventional, and Other

Updated Oct 23, 2026Eligibility revisedGo to Updates ↓
Phase
Phase 2
Study type
Interventional
Enrollment
10
Allocation
Not applicable
Ages
18 Years to 60 Years
Sex
All
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Study summary

The purpose of this study is to test the feasibility and tolerability of donepezil in a small group of patients with anorexia nervosa (AN). Study participants will be receiving care at the New York State Psychiatric Institute Eating Disorders Unit. Study medication will be increased from 1 mg per day to a maximum of 5 mg per day for up to 8 weeks. Participants will be closely monitored for side effects by a research psychiatrist every week, in addition to the regular clinical monitoring they receive during inpatient treatment. The study will also include assessments of habit strength to measure any changes in maladaptive eating habits over the course of the treatment.

Read the detailed description

Anorexia nervosa (AN) is a serious mental illness affecting up to 4% of women in the United States, with a chronic course and a mortality rate 6 times that expected for young women (Arcelus et al., 2011). The core, salient behavior in AN is maladaptive food restriction that persists even after full weight restoration treatment (Steinglass et al., 2023). Pharmacologic approaches to the treatment of AN, to date, have attempted to capitalize on side effect profiles (e.g., weight gain) or efficacy in related disorders (e.g., depression) but have yielded disappointing results (Muratore and Attia, 2022). This program of research leverages advances in mechanism research, which has identified the importance of habit systems in AN (Conceição et al., 2023), to test whether a medication can target habitual restrictive intake and thereby help patients with AN.

Donepezil is an acetylcholinesterase inhibitor and an FDA-approved medication that has been shown to reverse habitual behaviors like excessive exercise and food restriction in a rodent model of AN. Donepezil has been studied for its potential effect in mitigating compulsive, habit-like symptoms in other clinical populations, with no adverse events (Bergman et al., 2016; Cubo et al., 2008). These data suggest that donepezil may be effective in reducing maladaptive behaviors in compulsive disorders. There is no control product in this study.

Study medication will be initiated at 1mg, to be taken before bed. Dosing will follow a flexible titration. The expected titration will be 1 mg for 2 weeks, 2.5 mg for 2 weeks, then 5 mg for 4 weeks. The target dose of 5 mg/day is lower than the approved dose for dementia and the dose used in a study of adults with Obsessive Compulsive Disorder (OCD) (Bergman et al., 2016). Doses may be lowered from those recommended by the protocol if side effects are significant.

The primary objective of this study is to test the feasibility and tolerability of donepezil among patients with AN. The exploratory objectives are to test the utility of donepezil to modify the habitual behaviors characteristic of AN.

02

Conditions studied

  • Anorexia Nervosa

Keywords

  • anorexia
  • anorexia nervosa
  • donepezil
  • eating disorders
  • acetylcholinesterase inhibitor
  • Acetylcholine
  • habit
03

In context

Anorexia Nervosa

469 studies on the registry are indexed under Anorexia Nervosa; 127 are open to participants now.

This study's planned enrollment of 10 is below the median of 46 across 313 interventional studies indexed under Anorexia Nervosa.

Browse Anorexia Nervosa studies →

Lead sponsor

New York State Psychiatric Institute is the lead sponsor of 435 studies on the registry; 27 are open to participants now.

Of its 51 completed or terminated interventional studies of FDA-regulated products, 45 (88%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

The criteria were revised on the registry on Oct 23, 2026. See what changed

Ages eligible
18 Years to 60 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Provision of signed and dated form.
  2. Stated willingness to comply with all study procedures and availability for the duration of the study (Clinical interview).
  3. Aged 18-60 years (Clinical interview).
  4. Diagnosed with anorexia nervosa (EDA-5).
  5. ≥ 15 kg/m2 (Clinical team medical record)

Exclusion criteria

Exclusion Criteria:

  1. Score of High Risk on the Columbia Suicide Severity Scale (C-SSRS).
  2. Pregnancy (Serum pregnancy test on admission).
  3. Current diagnosis of schizophrenia, schizophreniform disorder, bipolar (type I), or substance use disorder (SCID).
  4. Bradycardia (below 60 bpm) (vital signs measurement by the clinical team)
  5. interval (QTc) greater than 480 ms at baseline ().
  6. Antipsychotic medication (antidepressants at a stable dose are allowed) (clinical interview).
  7. Citalopram treatment (clinical interview)
  8. Diagnosis of chornic obstructive pulmonary disease () or Asthma (clinical interview) 9 Known allergic reactions to components of the donepezil (e.g., known to donepezil hydrochloride) (clinical interview).

10. History of peptic ulcer disease (clinical interview). 11. History of arrhythmia (clinical interview).

Terms in these criteria, in plain language(6)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

BMI (body mass index)

Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.

What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.

QT and QTc

On an ECG, the QT interval is the time the heart’s lower chambers take to activate electrically and recover in each beat. QTc is that time adjusted for heart rate (QTcF by Fridericia’s formula, QTcB by Bazett’s). Some medicines lengthen it, and a long QTc can raise the risk of a dangerous heart rhythm.

The study may name a correction formula and a limit in milliseconds, often around 450–480.

ECG (electrocardiogram)

A recording of the heart’s electrical activity, taken with stickers on the chest, arms and legs. It takes a few minutes and does not hurt.

COPD

Chronic obstructive pulmonary disease: long-term lung disease that makes it hard to breathe out, including emphysema and chronic bronchitis.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

05

Study design

Phase
Phase 2
Primary purpose
Other
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
10 participants (estimated)

Study arms

  • Experimental
    Open Label

    Donepezil

    Drug: Donepezil

Interventions

  • Study medication will be initiated at 1mg, to be taken before bed. Dosing will follow a flexible titration. The expected titration will be 1 mg for 2 weeks, 2.5 mg for 2 weeks, then 5 mg for 4 weeks. Doses may be lowered from those recommended by the protocol if side effects are significant.

06

What researchers measure

Primary outcomes

  1. Side Effects Form

    The study psychiatrist will assess the tolerability of donepezil during weekly meetings with participants. The presence of side effects will be assessed using the Side Effects Form. Higher scores indicate more severe side effects (each side effect is scored separately). The Clinical Global Impressions (CGI) scale will evaluate overall functioning and psychopathology.

    Time frame: From enrollment to the end of treatment at 8 weeks

  2. Clinical Global Impressions Scale

    The Clinical Global Impressions Scale (CGI) is a seven-point scale. A score of 1 indicates the most positive change in the treatment course and the least severity of psychopathology, while a score of 7 indicates the most negative change in the treatment course and the highest severity of psychopathology.

    Time frame: From enrollment to the end of treatment at 8 weeks

Secondary outcomes

  1. Self-Report Habit Index

    The Self-Report Habit Index (SRHI) is a 12-item scale that measures habit strength. Higher scores indicate greater habit strength.

    Time frame: From enrollment to the end of treatment at 8 weeks

  2. Food Choice Task

    The Food Choice task is a computer based assessment of preferences for different foods. Higher scores indicate greater preferences. .

    Time frame: From enrollment to the end of treatment at 8 weeks

07

Study locations

1 site
08

References and documents

Publications

  • Attia E, Kaplan AS, Walsh BT, Gershkovich M, Yilmaz Z, Musante D, Wang Y. Olanzapine versus placebo for out-patients with anorexia nervosa. Psychol Med. 2011 Oct;41(10):2177-82. doi: 10.1017/S0033291711000390. Epub 2011 Mar 22. PubMed 21426603 ↗
  • Conceicao ISR, Garcia-Burgos D, de Macedo PFC, Nepomuceno CMM, Pereira EM, Cunha CM, Ribeiro CDF, de Santana MLP. Habits and Persistent Food Restriction in Patients with Anorexia Nervosa: A Scoping Review. Behav Sci (Basel). 2023 Oct 25;13(11):883. doi: 10.3390/bs13110883. PubMed 37998630 ↗
  • Cubo E, Fernandez Jaen A, Moreno C, Anaya B, Gonzalez M, Kompoliti K. Donepezil use in children and adolescents with tics and attention-deficit/hyperactivity disorder: an 18-week, single-center, dose-escalating, prospective, open-label study. Clin Ther. 2008 Jan;30(1):182-9. doi: 10.1016/j.clinthera.2008.01.010. PubMed 18343255 ↗
  • Steinglass JE, Fei W, Foerde K, Touzeau C, Ruggiero J, Lloyd C, Attia E, Wang Y, Walsh BT. Change in food choice during acute treatment and the effect on longer-term outcome in patients with anorexia nervosa. Psychol Med. 2024 Apr;54(6):1133-1141. doi: 10.1017/S0033291723002933. Epub 2023 Oct 2. PubMed 37781904 ↗
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  • El Mestikawy S, Wallen-Mackenzie A, Fortin GM, Descarries L, Trudeau LE. From glutamate co-release to vesicular synergy: vesicular glutamate transporters. Nat Rev Neurosci. 2011 Apr;12(4):204-16. doi: 10.1038/nrn2969. PubMed 21415847 ↗
  • Bergman J, Miodownik C, Lerner PP, Miodownik E, Shulkin A, Lerner V. Donepezil as Add-on Treatment for Resistant Obsessive-Compulsive Disorder: Retrospective Case Series. Clin Neuropharmacol. 2016 Jul-Aug;39(4):194-6. doi: 10.1097/WNF.0000000000000160. PubMed 27223667 ↗
  • Arcelus J, Mitchell AJ, Wales J, Nielsen S. Mortality rates in patients with anorexia nervosa and other eating disorders. A meta-analysis of 36 studies. Arch Gen Psychiatry. 2011 Jul;68(7):724-31. doi: 10.1001/archgenpsychiatry.2011.74. PubMed 21727255 ↗

Individual participant data

Plan to share: Undecided — This study aims to include a small number of participants, and privacy and confidentiality will need to be considered against the benefits of data sharing.

09

Timeline

1 registry update since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Start is estimated for Jan 2027; primary completion for Jun 2028, 17 months later.

How these figures are worked out, and which studies are left out of them.

Registered
Jul 19, 2024
First posted
Jul 25, 2024
StartEst.
Jan 2027
Primary completionEst.
Jun 2028
CompletionEst.
Dec 2028
Last update
Oct 23, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
Eligibility
3 exclusion criteria edited
What changed in the criteria
Exclusion criteria
  • EditedHistory of arrhythmiaCitalopram treatment (clinical interview).
  • EditedDiagnosis of chornic obstructive pulmonary disease (COPD) or Asthma (clinical interview) 9 Known allergic reactions to components of the donepezil (e.g., known hypersensitivity to donepezil hydrochloride) (clinical interview).
  • Edited10. History of peptic ulcer disease (clinical interview). 11. History of arrhythmia (clinical interview).
Oct 23, 2026
Show all 1 update
  1. Oct 23, 2026
    Eligibility 3 exclusion criteria edited
    What changed in the criteria
    Exclusion criteria
    • EditedHistory of arrhythmiaCitalopram treatment (clinical interview).
    • EditedDiagnosis of chornic obstructive pulmonary disease (COPD) or Asthma (clinical interview) 9 Known allergic reactions to components of the donepezil (e.g., known hypersensitivity to donepezil hydrochloride) (clinical interview).
    • Edited10. History of peptic ulcer disease (clinical interview). 11. History of arrhythmia (clinical interview).
    + 1 other change: verification date

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT06518941
Responsible party
Joanna Steinglass (Professor of Psychiatry, New York State Psychiatric Institute) — Principal investigator
First posted
Jul 25, 2024
Start date
Jan 2027 (estimated)
Primary completion
Jun 2028 (estimated)
Completion
Dec 2028 (estimated)
Last update
Oct 23, 2026

Study contacts

Joanna Steinglass, MD
Contact
js1124@cumc.columbia.edu
646-775-6345

Oversight

FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is not yet recruiting, as verified in Oct 2026. You cannot join it, but the record below documents what was studied.

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Discussion

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Studies of the drug tested here: Donepezil

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