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The Current Status of the Ketogenic Diet in Psychiatry

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Bostock, ECS, Kirkby, KC ORCID: 0000-0002-4730-1199 and Taylor, BVM 2017 , 'The Current Status of the Ketogenic Diet in Psychiatry' , Frontiers in Psychiatry, vol. 8 , pp. 1-10 , doi: 10.3389/fpsyt.2017.00043.

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Abstract

Background: The ketogenic diet (KD) has been used in treatment-resistant epilepsysince the 1920s. It has been researched in a variety of neurological conditions in bothanimal models and human trials. The aim of this review is to clarify the potential role ofKD 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 disordersincluding anxiety, depression, bipolar disorder, schizophrenia, autism spectrum disorder(ASD), and attention deficit hyperactivity disorder (ADHD). These studies comprised nineanimal models, four case studies, and two open-label studies in humans. In anxiety,exogenous ketone supplementation reduced anxiety-related behaviors in a rat model. Indepression, KD significantly reduced depression-like behaviors in rat and mice models intwo controlled studies. In bipolar disorder, one case study reported a reduction in symptomatology,while a second case study reported no improvement. In schizophrenia, anopen-label study in female patients (n = 10) reported reduced symptoms after 2 weeksof KD, a single case study reported no improvement. In a brief report, 3 weeks of KD in amouse model normalized pathological behaviors. In ASD, an open-label study in children(n = 30) reported no significant improvement; one case study reported a pronouncedand sustained response to KD. In ASD, in four controlled animal studies, KD significantlyreduced ASD-related behaviors in mice and rats. In ADHD, in one controlled trial of KDin dogs with comorbid epilepsy, both conditions significantly improved.Conclusion: Despite its long history in neurology, the role of KD in mental disorders isunclear. Half of the published studies are based on animal models of mental disorderswith limited generalizability to the analog conditions in humans. The review lists somemajor limitations including the lack of measuring ketone levels in four studies and theissue of compliance to the rigid diet in humans. Currently, there is insufficient evidencefor the use of KD in mental disorders, and it is not a recommended treatment option.Future research should include long-term, prospective, randomized, placebo-controlledcrossover dietary trials to examine the effect of KD in various mental disorders.

Item Type: Article
Authors/Creators:Bostock, ECS and Kirkby, KC and Taylor, BVM
Keywords: ketogenic diet, psychiatry, mental disorders, ketones, epilepsy
Journal or Publication Title: Frontiers in Psychiatry
Publisher: Frontiers Research Foundation
ISSN: 1664-0640
DOI / ID Number: 10.3389/fpsyt.2017.00043
Copyright Information:

Copyright 2016 the authors. Licensed under Creative Commons Attribution 4.0 International (CC BY 4.0) https://creativecommons.org/licenses/by/4.0/This Document is Protected by copyright and was first published by Frontiers. All rights reserved. It is reproduced with permission.

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