Ketogenic Therapy for Mental Illness

What did the new ketogenic therapy training study find?

Published September 22 in Frontiers in Psychiatry, the University of Maryland study combined four hours of online education with an optional four-week ketogenic diet experience. Participants rated their ability to implement the therapy and discuss treatment decisions more highly afterward. These were self-assessments, rather than independently tested clinical skills.

The uncontrolled design cannot establish whether training improved care. The paper also disclosed Baszucki Foundation funding and authors' interests in ketogenic services or education. Its practical contribution is identifying a possible training approach; patient effectiveness remains a separate question. [Read the training study](https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2026.1913325/full).

Can ketogenic therapy improve bipolar disorder or schizophrenia?

In a trial published in Schizophrenia Bulletin in July, researchers assigned 28 participants with schizophrenia-spectrum or bipolar I disorders to a ketogenic diet and 30 to their usual diet for one month. The ketogenic group showed improvements in weight, insulin resistance and HbA1c, a blood marker used to assess glucose control. These findings matter because psychiatric illness and some medications can be accompanied by substantial metabolic problems. [Read the randomized trial](https://doi.org/10.1093/schbul/sbag082).

A subgroup of 25 participants completed four months of ketogenic therapy and showed improvements in psychiatric symptoms and cognitive performance compared with their own starting measurements. However, this longer phase lacked a concurrent randomized comparison group. The results therefore cannot isolate the diet's contribution from other influences. The association between higher ketones and improved depressive symptoms also does not prove that ketones caused the improvement. Longer controlled studies need to establish durability, safety and which patients benefit. [Trial methods and findings](https://doi.org/10.1093/schbul/sbag082).

How could ketogenic therapy fit alongside psychiatric medication?

A ketogenic diet sharply reduces carbohydrate intake so the body produces more ketones from fat. Researchers are investigating whether this alternative fuel affects brain energy use and signaling. These proposed mechanisms remain under study in psychiatric disorders. Stanford Medicine describes ketogenic therapy as supplemental to established mental health treatment and emphasizes coordination with an experienced physician and nutrition professional. Patients should not stop antipsychotics or mood stabilizers to try the diet. [Stanford Medicine's clinical explanation](https://med.stanford.edu/news/insights/2025/04/keto-diet-ketogenic-therapy-mental-illness-bipolar.html).

Safety assessment extends beyond measuring ketones. International recommendations developed largely from adult epilepsy practice describe constipation, gastrointestinal symptoms and increases in blood lipids, alongside the need to assess nutritional adequacy. Kidney stones, pregnancy and certain metabolic disorders require particular consideration. Baseline testing and follow-up can help identify problems, while medication review determines whether additional monitoring is needed. These recommendations inform dietary safety; they do not establish effectiveness for mental illness. [Adult ketogenic therapy recommendations](https://pmc.ncbi.nlm.nih.gov/articles/PMC8610544/).