Globally, an estimated 85 million people suffer from serious, persistent bipolar mood and psychotic illnesses. While many therapeutic drugs can be helpful for these issues, a major problem is that many individuals don’t respond well to these medications. For example, 50% of people receiving treatment for bipolar disorder continue to experience recurrent mood episodes. In addition, many of these medications come with harsh side effects that significantly impact metabolic health–such as increased insulin resistance and increased risk of cardiovascular disease.
Clearly this is a serious issue that needs more attention, awareness, and research. Even celebrities like Shawn Mendes are coming out publicly to talk more about mental health and how important it is to take care of it. Fortunately, research in this area is growing and investigating various nutrition, exercise, supplement, drug, and other interventions that will be important to help this field move forward. Recently, a study was published looking at 31 patients with treatment-refractory mental illness treated with a ketogenic diet in a semi-controlled hospital setting.
The Basics of the Study on Mental Health and Keto
28 adults whose chronic psychiatric symptoms were poorly controlled despite intensive psychopharmacological management were admitted to the Clinique du Castelviel and placed on a ketogenic diet. The breakdown of the ketogenic diet was based on Dr. Eric Westman’s protocol of 20 total grams of carbohydrates per day, 15-20% of calories from protein, and 75-80% of calories coming from fat. Participants were provided with 3 protocol-compliant meals per day.
What Did the Study Find?
The authors note that even though dietary adherence was excellent in 11 patients (39%), good in 12 patients (43%), and fair in 5 patients (18%), noticeable improvements in mood and psychotic symptoms were observed in all 28 patients (100%) during the intervention, typically within 3 weeks or less of initiating the ketogenic diet. In the individuals with schizophrenia, all 10 (100%) patients showed improvements in their PANSS scores, with the average score falling from 91.4 to 49.3.
The Hamilton Depression Rating Scale (HAM-D) was administered to 23 of 28 patients. All 23 (100%) patients exhibited improvement in HAM-D scores, with the average score falling from 25.4 to 7.7.
In addition, by the end of the study, the number and/or dosage of psychotropic medications had been reduced in 18 of 28 (64%) patients. Lastly, many markers of metabolic health improved in these individuals. On average, subjects lost 10.8 pounds, lowered fasting blood glucose, hemoglobin A1c, systolic and diastolic blood pressure, and gamma-glutamyl transferase (GGT) over the course of the study.
Key Takeways on Keto and Mental Health
Though this was small study, the results are very promising. One major challenge is that individuals were permitted to leave the unit on weekends, which likely lead to lower-than-expected dietary compliance. Still, this type of research is desperately needed and strongly indicates that the ketogenic diet is feasible, safe, and results in considerable improvements in mental health symptoms like depression as well as in multiple markers of metabolic health. Hopefully more research continues to explore the use of ketogenic therapies for the treatment of serious mood and psychotic illnesses.
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