TY - JOUR
T1 - A pilot study of a ketogenic diet in bipolar disorder
T2 - clinical, metabolic and magnetic resonance spectroscopy findings
AU - Campbell, Iain H
AU - Needham, Nicole
AU - Grossi, Helen
AU - Kamenska, Ivana
AU - Luz, Saturnino
AU - Sheehan, Shane
AU - Thompson, Gerard
AU - Thrippleton, Michael J
AU - Gibbs, Melissa C
AU - Leitao, Joana
AU - Moses, Tessa
AU - Burgess, Karl
AU - Rigby, Benjamin P
AU - Simpson, Sharon A
AU - McIntosh, Emma
AU - Brown, Rachel
AU - Meadowcroft, Ben
AU - Creasy, Frances
AU - Mitchell-Grigorjeva, Maja
AU - Norrie, John
AU - McLellan, Ailsa
AU - Fisher, Cheryl
AU - Zieliński, Tomasz
AU - Gaggioni, Giulia
AU - Campbell, Harry
AU - Smith, Daniel J
PY - 2025/2/25
Y1 - 2025/2/25
N2 - BACKGROUND: Preliminary evidence suggests that a ketogenic diet may be effective for bipolar disorder.AIMS: To assess the impact of a ketogenic diet in bipolar disorder on clinical, metabolic and magnetic resonance spectroscopy outcomes.METHOD: Euthymic individuals with bipolar disorder (N = 27) were recruited to a 6- to 8-week single-arm open pilot study of a modified ketogenic diet. Clinical, metabolic and MRS measures were assessed before and after the intervention.RESULTS: Of 27 recruited participants, 26 began and 20 completed the ketogenic diet. For participants completing the intervention, mean body weight fell by 4.2 kg (P < 0.001), mean body mass index fell by 1.5 kg/m2 (P < 0.001) and mean systolic blood pressure fell by 7.4 mmHg (P < 0.041). The euthymic participants had average baseline and follow-up assessments consistent with them being in the euthymic range with no statistically significant changes in Affective Lability Scale-18, Beck Depression Inventory and Young Mania Rating Scale. In participants providing reliable daily ecological momentary assessment data (n = 14), there was a positive correlation between daily ketone levels and self-rated mood (r = 0.21, P < 0.001) and energy (r = 0.19 P < 0.001), and an inverse correlation between ketone levels and both impulsivity (r = -0.30, P < 0.001) and anxiety (r = -0.19, P < 0.001). From the MRS measurements, brain glutamate plus glutamine concentration decreased by 11.6% in the anterior cingulate cortex (P = 0.025) and fell by 13.6% in the posterior cingulate cortex (P = <0.001).CONCLUSIONS: These findings suggest that a ketogenic diet may be clinically useful in bipolar disorder, for both mental health and metabolic outcomes. Replication and randomised controlled trials are now warranted.
AB - BACKGROUND: Preliminary evidence suggests that a ketogenic diet may be effective for bipolar disorder.AIMS: To assess the impact of a ketogenic diet in bipolar disorder on clinical, metabolic and magnetic resonance spectroscopy outcomes.METHOD: Euthymic individuals with bipolar disorder (N = 27) were recruited to a 6- to 8-week single-arm open pilot study of a modified ketogenic diet. Clinical, metabolic and MRS measures were assessed before and after the intervention.RESULTS: Of 27 recruited participants, 26 began and 20 completed the ketogenic diet. For participants completing the intervention, mean body weight fell by 4.2 kg (P < 0.001), mean body mass index fell by 1.5 kg/m2 (P < 0.001) and mean systolic blood pressure fell by 7.4 mmHg (P < 0.041). The euthymic participants had average baseline and follow-up assessments consistent with them being in the euthymic range with no statistically significant changes in Affective Lability Scale-18, Beck Depression Inventory and Young Mania Rating Scale. In participants providing reliable daily ecological momentary assessment data (n = 14), there was a positive correlation between daily ketone levels and self-rated mood (r = 0.21, P < 0.001) and energy (r = 0.19 P < 0.001), and an inverse correlation between ketone levels and both impulsivity (r = -0.30, P < 0.001) and anxiety (r = -0.19, P < 0.001). From the MRS measurements, brain glutamate plus glutamine concentration decreased by 11.6% in the anterior cingulate cortex (P = 0.025) and fell by 13.6% in the posterior cingulate cortex (P = <0.001).CONCLUSIONS: These findings suggest that a ketogenic diet may be clinically useful in bipolar disorder, for both mental health and metabolic outcomes. Replication and randomised controlled trials are now warranted.
KW - Bipolar disorder
KW - ketogenic diet
KW - ketosis
KW - magnetic resonance spectroscopy
KW - metabolic psychiatry
U2 - 10.1192/bjo.2024.841
DO - 10.1192/bjo.2024.841
M3 - Article
C2 - 39995103
SN - 2056-4724
VL - 11
JO - BJPsych Open
JF - BJPsych Open
IS - 2
M1 - e34
ER -