Pilot study of a ketogenic diet in bipolar disorder.

Abstract

BACKGROUND:

Recent evidence from case reports suggests that a ketogenic diet may be effective for bipolar disorder. However, no clinical trials have been conducted to date.

AIMS:

To assess the recruitment and feasibility of a ketogenic diet intervention in bipolar disorder.

METHOD:

Euthymic individuals with bipolar disorder were recruited to a 6-8 week trial of a modified ketogenic diet, and a range of clinical, economic and functional outcome measures were assessed. Study registration number: ISRCTN61613198.

RESULTS:

Of 27 recruited participants, 26 commenced and 20 completed the modified ketogenic diet for 6-8 weeks. The outcomes data-set was 95% complete for daily ketone measures, 95% complete for daily glucose measures and 95% complete for daily ecological momentary assessment of symptoms during the intervention period. Mean daily blood ketone readings were 1.3 mmol/L (s.d. = 0.77, median = 1.1) during the intervention period, and 91% of all readings indicated ketosis, suggesting a high degree of adherence to the diet. Over 91% of daily blood glucose readings were within normal range, with 9% indicating mild hypoglycaemia. Eleven minor adverse events were recorded, including fatigue, constipation, drowsiness and hunger. One serious adverse event was reported (euglycemic ketoacidosis in a participant taking SGLT2-inhibitor medication).

CONCLUSIONS:

The recruitment and retention of euthymic individuals with bipolar disorder to a 6-8 week ketogenic diet intervention was feasible, with high completion rates for outcome measures. The majority of participants reached and maintained ketosis, and adverse events were generally mild and modifiable. A future randomised controlled trial is now warranted.

• Authors: Nicole Needham, Iain H Campbell, Helen Grossi, Ivana Kamenska, Benjamin P Rigby, Sharon A Simpson, Emma McIntosh, Pankaj Bahuguna, Ben Meadowcroft, Frances Creasy, Maja Mitchell-Grigorjeva, John Norrie, Gerard Thompson, Melissa C Gibbs, Ailsa McLellan, Cheryl Fisher, Tessa Moses, Karl Burgess, Rachel Brown, Michael J Thrippleton, Harry Campbell, Daniel J Smith
• Journal: BJPsych open (BJPsych Open) Vol. 9 Issue 6 Pg. e176 (Oct 10 2023) ISSN: 2056-4724 [Print] England
• PMID: 37814952 (Publication Type: Journal Article)