Psychiatric Disorders

A pilot study of a ketogenic diet in bipolar disorder: clinical, metabolic, and magnetic resonance spectroscopy findings

A pilot study explored the effects of a ketogenic diet on individuals with bipolar disorder, focusing on clinical, metabolic, and brain function changes. In this study, 20 euthymic individuals with bipolar disorder followed a modified ketogenic diet for 6 to 8 weeks.

Throughout the intervention, participants underwent clinical mood assessments, metabolic evaluations, daily self-reported tracking of mood and energy levels, and daily blood ketone and blood glucose testing. The study dietitian adjusted participants’ macronutrient ratios throughout the study to maintain ketosis, targeting beta-hydroxybutyrate (BHB) levels between 1–4 mmol/L. Brain metabolic changes were analyzed using magnetic resonance spectroscopy (MRS).

Key Findings:

• Among the 14 participants who provided consistent daily assessment data:
  • Daily BHB levels were positively correlated with self-rated mood and energy levels
  • Daily BHB levels showed an inverse correlation with impulsivity and anxiety
• Metabolic Improvements:
  • Participants lost an average of 9.2 lbs (4.2 kg)
  • BMI decreased by an average of 1.5 kg/m²
  • Systolic blood pressure dropped by an average of 7.4 mmHg
• Brain Metabolism Changes (MRS data):
  • Glutamate and glutamine levels, which are typically elevated in individuals with bipolar disorder, decreased

This study provides preliminary evidence that a ketogenic diet may offer both metabolic and mental health benefits for individuals with bipolar disorder. The correlations between higher ketones and improved mood, energy, and reduced impulsivity/anxiety highlight potential therapeutic effects of ketosis. Additionally, weight loss and blood pressure improvements suggest metabolic advantages. Larger randomized controlled trials are necessary to confirm these findings and further investigate the mechanisms behind these effects.