New Research - Keto Trial Promises New Treatment Option in Bipolar Disorder

Research

Decades of rigorous scientific evidence demonstrate that mental illness often arises from metabolic dysfunction that affects the brain.

Landmark Clinical Trials

An evidence-based metabolic intervention used in neurology for 100 years–therapeutic ketogenic diet–is now being studied for serious mental illnesses in more than 20 clinical trials around the world.

The first scientific papers resulting from these trials show that a ketogenic intervention in psychiatry was not only safe and feasible, but also led to improvements in both metabolic and mental health.

First European Trial Shows Promise of Keto as a New Treatment for Bipolar

February, 2025. First-of-its-kind European pilot study leads to weight loss and lower blood pressure, along with improvements in mood, energy and anxiety—fueling hope for a new treatment for bipolar disorder.

Additional Publications

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Stanford Study Shows Keto Improves Symptoms of Serious Mental Illness

April, 2024. New findings of a pioneering Stanford pilot study published in Psychiatry Research show dramatic improvements in psychiatric and metabolic outcomes in bipolar disorder and schizophrenia.

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Century of Progress

A century of research and clinical experience has shown that restoring healthy brain metabolism with a metabolic intervention, like a ketogenic diet, can stop seizures in epilepsy.

A Mental or Metabolic Problem?

Growing scientific literature shows that, just like in seizure disorders, energy metabolism is impaired in those suffering from serious mental illness.

An Explosion in Research

Basic, translational and interventional clinical trials are underway around the world investigating the connection between brain metabolism, mitochondrial function and mental illness.

Emerging Evidence

Accumulating scientific literature indicates that reversing metabolic dysfunction can help heal the brain in serious mental illnesses like schizophrenia, bipolar disorder, major depression, and anorexia.

Accumulating scientific literature indicates that reversing metabolic dysfunction can help heal the brain in serious mental illnesses like schizophrenia, bipolar disorder, major depression, and anorexia.

The Ketogenic Diet as a Transdiagnostic Treatment for Neuropsychiatric Disorders: Mechanisms and Clinical Outcomes

Dr. Chris Palmer and colleagues present a systematic review of ketogenic therapy as a transdiagnostic treatment for mental health disorders.

Ketogenic Diet for Refractory Mental Illness:
A Retrospective Analysis of 31 Inpatients

Dr. Albert Danan showed that in a French cohort of treatment-resistant inpatients, all experienced weight loss and psychiatric symptom reduction, with nearly half no longer meeting criteria for mental illness after treatment.

Complete Remission of Depression and Anxiety Using a Ketogenic Diet: Case Series

Dr. Lori Calabrese and colleagues present a case series of three adults who achieve complete remission of major depression and generalized anxiety disorder.

Understanding the Experiences of Ketogenic Metabolic Therapy for People Living with Varying Levels of Depressive Symptoms: A Thematic Analysis

Dr. Erin Bellamy and colleagues analyze lived experience accounts of ketogenic therapy for depressive symptoms, finding that the benefits of a ketogenic diet outweigh the cons for participants.

Treating Insulin Resistance With Metformin as a Strategy to Improve Clinical Outcomes in Treatment-Resistant Bipolar Depression

Dr. Cynthia Calkin and colleagues demonstrate that improving insulin sensitivity in treatment-resistant bipolar depression led to remission after decades of illness.

The Role of Ketogenic Metabolic Therapy on the Brain in Serious Mental Illness: A Review

Drs. Shebani Sethi and Judy Ford call for more clinical trials to address the potential beneficial effects of the ketogenic diet in people with serious mental illness.

Ketogenic Therapy in Serious Mental Illness:
Emerging Evidence

In this commentary, Drs. Chris Palmer and Zoltan Sarnyai review the emerging evidence supporting the use of nutritional ketosis as a treatment for serious mental illness.

Animal-Based Ketogenic Diet Puts Severe Anorexia Nervosa into Multi-Year Remission: A Case Series

Researchers at Harvard published this case series suggesting a ketogenic diet may be useful for some patients with anorexia nervosa.

Metabolic Insights into Neuropsychiatric Illnesses and Ketogenic Therapies: A Transcriptomic View

Sahay et al. demonstrate that disruptions in metabolic pathways are linked to serious mental illness and suggest that ketogenic interventions may help restore metabolic balance based on gene expression data analysis.

Retrospective Case Study: Ketogenic Metabolic Therapy in the Effective Management of Treatment-Resistant Depressive Symptoms in Bipolar Disorder

Nicole Laurent, LMHC, shares how ketogenic therapy improved treatment-resistant depressive symptoms in a patient with bipolar disorder, leading to a stabilized mood, enhanced quality of life, and reduced medication dependence.

The Effects of Ketogenic Metabolic Therapy on Mental Health and Metabolic Outcomes in Schizophrenia and Bipolar Disorder: A Randomized Controlled Clinical Trial Protocol

Longhitano, Sarnyai, and colleagues present a clinical trial protocol examining the effects of ketogenic therapy on psychiatric and metabolic outcomes in schizophrenia and bipolar disorder over a 14-week period.

Exploring the Potential of the Ketogenic Diet in Autism Spectrum Disorder: Metabolic, Genetic, and Therapeutic Insights

Schrickel et al. review how a ketogenic diet may benefit individuals with autism spectrum disorder by addressing underlying metabolic and neuroprotective mechanisms.

Ketogenic Metabolic Therapy For Schizoaffective Disorder: A Retrospective Case Series of Psychotic Symptom Remission and Mood Recovery

Laurent et al. present a case series of two individuals who experienced full remission of psychotic and mood symptoms after implementing ketogenic metabolic therapy.

Clinical Trials

More than a dozen clinical trials of ketogenic therapy for serious mental illness are now completed or underway for conditions that include major depression, schizophrenia spectrum disorder, bipolar disorder, and anorexia.

Additional trials not listed here are in process for many other brain-based disorders, including anxiety, Alzheimer's disease, autism, post-traumatic stress disorder, and alcohol use disorder.

More than a dozen clinical trials of ketogenic therapy for serious mental illness are now completed or underway for conditions that include major depression, schizophrenia spectrum disorder, bipolar disorder, and anorexia.

Additional trials not listed here are in process for many other brain-based disorders, including anxiety, Alzheimers, autism, PTSD, and alcohol use disorder.

Additional trials not listed here are in process for many other brain-based disorders, including anxiety, Alzheimer's disease, autism, post-traumatic stress disorder, and alcohol use disorder.

Completed Clinical Trials

Results of the first completed clinical trials of a ketogenic diet in serious mental illness since the 1960’s are now emerging.

Impact of a Ketogenic Diet on Metabolic and Psychiatric Health in Bipolar or Schizophrenia Illness

Dr. Shebani Sethi’s 4-month clinical trial at Stanford of ketogenic diet for serious mental illness showed promising preliminary results indicating remission of bipolar disorder and schizophrenia in participants who adhered to the diet, as well as reversal of metabolic syndrome for those with the diagnosis.

Diagnosis

Schizophrenia, Bipolar disorder

Principal Investigator

Shebani Sethi, MD

Institution

Stanford University

Location

Stanford, California

Feature Video

Trailblazing Stanford Trial Shows Keto Improves Serious Mental Illness - with Dr. Shebani Sethi

Modified Ketogenic Diet and Ketamine for Anorexia Nervosa

A small pilot trial demonstrated safety and efficacy for adults with chronic psychopathology and supports specific neurobiological mechanisms that can be normalized using therapeutic ketogenic diet and ketamine.

Diagnosis

Anorexia Nervosa

Principal Investigator

Lori Calabrese, MD

Institution

N/A

Location

Some people diagnosed with psychotic disorders have trouble using sugar as energy for their brain. This study investigates the impact of a ketogenic diet on depression and anxiety and psychotic symptoms such as delusions. Additionally, the study investigates the feasibility of a ketogenic diet in an inpatient setting.

Diagnosis

Psychotic symptoms

Principal Investigator

Anu Ruusunen, PhD

Institution

Kuopio University Hospital

Location

Kuopio, Finland

Ketogenic Diet in People With Schizophrenia

A ketogenic diet shows promise for treating schizophrenia and schizoaffective disorder. This study will evaluate the effects of a ketogenic diet on schizophrenia and schizoaffective disorder in an inpatient setting.

Diagnosis

Schizophrenia, Schizoaffective disorder

Principal Investigator

Deanna Kelly, PharmD

Institution

University of Maryland, Baltimore

Location

Cantonsville, Maryland

Feature Video

Why Did the Maryland Health Department Halt a Critical Schizophrenia Study? - with Dr. Deanna Kelly

The Effects of Diet on Metabolic and Mental Health Outcome Measures in Bipolar Disorder and Schizophrenia: A Randomized Controlled Clinical Trial

This study looks at the impact of dietary intervention alongside treatment in patients with a diagnosis of bipolar disorder, schizophrenia or schizoaffective disorder.

Diagnosis

Schizophrenia, Bipolar disorder

Principal Investigator

Calogero Longhitano, MD & Zoltan Sarnyai, MD, PhD

Institution

James Cook University

Location

Queensland, Australia

Feature Video

Serious mental illnesses like schizophrenia, bipolar disorder, and major depression affect hundreds of millions of people and are often linked to metabolic issues, reducing life expectancy. This randomized clinical trial (RCT) will study whether a ketogenic diet, which improves brain energy use and metabolism, can enhance quality of life and mental health outcomes for individuals with these conditions.

Diagnosis

Schizophrenia, Depression, Bipolar disorder

Principal Investigator

Shebani Sethi, MD

Institution

Stanford University

Location

Palo Alto, California

Metabolic Mind Research Videos

Hosted by Dr. Bret Scher, your go-to resource for up-to-date science and news in metabolic psychiatry.

Metabolic Mind YouTube Channel

Metabolic Mind
Research Videos

Hosted by Dr. Bret Scher, your go-to resource for up-to-date science and news in metabolic psychiatry.

Metabolic Mind YouTube Channel

Metabolic Mind
Research Videos

Hosted by Dr. Bret Scher, your go-to resource for up-to-date science and news in metabolic psychiatry.

Metabolic Mind YouTube Channel

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