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Cited by 127Diet and metabolism studiesDietary Effects on HealthTreatment of Major Depression

The Current Status of the Ketogenic Diet in Psychiatry

Open access
Bostock, Emmanuelle C. S., Kirkby, Kenneth C., Taylor, Bruce V. M.·2017·Frontiers in Psychiatry
DOI 10.3389/fpsyt.2017.00043PMC PMC5357645
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Abstract

Background The ketogenic diet (KD) has been used in treatment-resistant epilepsy since the 1920’s. It has been researched in a variety of neurological conditions in both animal models and human trials. The aim of this review is to clarify the potential role of KD in psychiatry. Methods Narrative review of electronic databases PubMED, PsychINFO and Scopus. Results The search yielded 15 studies that related the use of KD in mental disorders including anxiety, depression, bipolar disorder, schizophrenia, autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD). These studies comprised nine animal models, four case studies and two open-label studies in humans. In anxiety, exogenous ketone supplementation reduced anxiety-related behaviours in a rat model. In depression, KD significantly reduced depression-like behaviours in rat and mice models in two controlled studies. In bipolar disorder, one case study reported a reduction in symptomatology a second case study no improvement. In schizophrenia, an open-label study in female patients (n=10) reported reduced symptoms after two weeks of KD, a single case study reported no improvement. In a brief report, three weeks of KD in a mouse model normalized pathological behaviours. In ASD an open-label study in children (n=30) reported no significant improvement; one case study a pronounced and sustained response to KD. In ASD, in four controlled animal studies, KD significantly reduced ASD-related behaviours in mice and rats. In ADHD, in one controlled trial of KD in dogs with co-morbid epilepsy, both conditions significantly improved. Conclusions Despite its long history in neurology, the role of KD in mental disorders is unclear. Half of the published studies are based on animal models of mental disorders with limited generalizability to the analogue conditions in humans. The review lists some major limitations including the lack of measuring ketone levels in four studies and the issue of compliance to the rigid diet in humans. Currently there is insufficient evidence for the use of KD in mental disorders and it is not a recommended treatment option. Future research should include long-term, prospective, randomized, placebo-controlled crossover dietary trials to examine the effect of KD in various mental disorders.

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  • A ketogenic diet can offer beneficial health effects towards ameliorating symptoms of neurological conditions including autism, depression, epilepsy, cancer, Alzheimer's and Parkinson's diseases.

    “Therefore, a ketogenic diet can offer beneficial health effects towards ameliorating symptoms of neurological conditions including autism, depression, epilepsy, cancer, Alzheimer's and Parkinson's diseases (Bostock et al., 2017;Gasior et al., 2006;Lange et al., 2017).”

    From The Microbiota-Gut-Brain Axis (2019) · cites this paper as Bostock et al., 2017

    The Introduction (page unavailable) describes the ketogenic diet as effective for difficult-to-control epilepsy and reports improvements in small Parkinson’s studies; the Results sections report improvements in some autism studies and depression-like behavior in rodents. The Alzheimer’s improvement followed an oral ketogenic compound, not a ketogenic diet. The Introduction associates cancer with altered energy production but does not report that the diet ameliorates cancer symptoms, so the full list is not supported. (LLM, conf=0.89)

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Authors
Bostock, E. C. S., Kirkby, K. C., & Taylor, B. V. M.
Affiliations
  • University of Tasmania (AU)
  • Menzies Institute for Medical Research (AU)
Corresponding author
Bostock, Emmanuelle C. S.
ORCID
Venue
Frontiers in Psychiatry
Publisher
Frontiers Media SA
Published
2017-03-20
Volume
8
Pages
43-43
ISSN
1664-0640 (ISSN-L)
DOI
10.3389/fpsyt.2017.00043
PMC
PMC5357645
OpenAlex
W2594571195
Cited by
127
References
108
Citations by year
2026: 5 · 2025: 14 · 2024: 18 · 2023: 14 · 2022: 22 · 2021: 15 · 2020: 13 · 2019: 11 · 2018: 12 · 2017: 3
FWCI
1.31
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Frontiers in Psychiatry (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • UTAS Research Repository (acceptedVersion)
  • eCite Digital Repository (University of Tasmania) (submittedVersion, cc-by)
  • Figshare (submittedVersion, cc-by)
Funders
University of Tasmania (BT000001)
Topics
  • Health Sciences › Medicine › Physiology › Diet and metabolism studies
  • Health Sciences › Medicine › Physiology › Dietary Effects on Health
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
Keywords
ketogenic diet, mental illness, anxiety, depression, bipolar disorder, schizophrenia, autism spectrum disorder, attention deficit hyperactivity disorder, exogenous ketone supplementation, animal models of psychiatric disorders, drug-resistant epilepsy, dietary adherence, ketone levels

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