Scientific and Clinical Rationale for the Use of a Ketogenic Diet in Psychiatric Disorders

Thank you for considering the ketogenic diet as a psychiatric treatment for patients. If you are a prescriber you are in a specialized role to help individuals willing to try dietary intervention as a treatment for a variety of psychiatric and neurological symptoms. Your help in the monitoring, adjustment, and even possible titration of medication, as you deem appropriate, is much-needed assistance to patients on their journey to better functioning and healthier lives.

I and a number of clinicians, including those in the psychiatry field, have found the ketogenic diet to be a useful addition to conventional care. In particular for those that do not fully respond to medication alone or who hope to reduce their overall number of medications and potential side effects. In many cases, exploration of the use of a ketogenic diet comes from the patient directly or their family in hopes of improving their quality of life.

As with any intervention, the ketogenic diet does not help everyone. Personally, I have seen improvements happen within 3 months of implementation. This is consistent with what I hear from other clinicians using this type of intervention. With the help of open-minded prescribers, some patients are able to reduce or eliminate their use of medications. In those that continue medication, the metabolic benefits of the ketogenic diet can mitigate the side effects of common psychiatric medications and benefit the patient greatly.

The below additional resources are provided for your convenience.


Please see Georgia Ede, MD’s comprehensive training on the use of Ketogenic Diets for Mental Illness and Neurological Disorders


Ketogenic diet as a metabolic treatment for mental illness

Open access peer-reviewed paper authored by researchers at Stanford, Oxford, and Harvard Universities

https://pubmed.ncbi.nlm.nih.gov/32773571


Clinical trials are occurring, including those specific to the study of ketogenic diets in bipolar and psychotic disorders at Stanford University

https://www.clinicaltrials.gov/ct2/show/NCT03935854



Clinical Guidelines for Therapeutic Carbohydrate Restriction


Free CME course

Treating metabolic syndrome, type 2 diabetes, and obesity with therapeutic carbohydrate restriction

  • Use therapeutic carbohydrate restriction to treat patients with metabolic syndrome, type 2 diabetes, and obesity.
  • Determine which patients will benefit from therapeutic carbohydrate restriction, what precautions should be considered, and why.
  • Provide comprehensive education on beginning and sustaining therapeutic carbohydrate restriction to patients for whom it is appropriate.
  • Safely adjust diabetes and blood pressure medications during the initiation and maintenance of therapeutic carbohydrate restriction.
  • Monitor, evaluate, and troubleshoot patient progress while using therapeutic carbohydrate restriction.

https://www.dietdoctor.com/cme


Metabolic Multiplier

This site has a useful list of training opportunities in ketogenic metabolic therapy for different healthcare professionals and specific conditions.


You may also find the Mental Health Keto Blog to be helpful in understanding how underlying mechanisms of pathology in several mental illnesses can be treated using a ketogenic diet.