The ketogenic diet has long been known for its use in treatment-resistant epilepsy, but attention is now turning to its potential benefits in mental illness as well.
Could something as simple as a diet actually improve notoriously difficult-to-treat conditions including major depressive disorder, bipolar disorder, and schizophrenia?
The evidence to date has been less rigorous than gold-standard randomized controlled trials. But new studies are underway, and more clinicians are keen to explore reports of patients whose psychiatric conditions improved when they adhered to a ketogenic diet.
Nonetheless, there are challenges inherent to dietary intervention trials that must be mitigated, and broader buy-in from the medical community at large remains to be seen.
“There have to be randomized trials before we can make enthusiastic and evidence-based treatment recommendations,” Drew Ramsey, MD, a nutritional psychiatrist and member of the American Psychiatric Association, told MedPage Today. “That said, I’m hopeful and optimistic that patients are going to have more tools to treat their mental health disorders.”
What Does the Evidence Say?
Ramsey noted that some randomized controlled trials have shown that dietary interventions — albeit not specifically the ketogenic diet — can help improve depression. For instance, the SMILES trial showed better symptomatic improvement and remission rates with a dietary intervention compared with a control social support group, and the AMMEND study showed greater improvements in symptoms and quality of life for young men on the Mediterranean diet compared with controls.
As for the ketogenic diet specifically, Georgia Ede, MD, a nutritional psychiatrist based in Massachusetts, told MedPage Today that the body of research for its use in psychiatric conditions “is really starting to grow.”
Ede co-authored a French study published in Frontiers in Psychiatry in 2022 entitled, “The Ketogenic Diet for Refractory Mental Illness: A Retrospective Analysis of 31 Inpatients.”
Patients with severe and persistent mental…