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The Ketogenic Diet for Refractory Mental Illness: A Retrospective Analysis of 31 Inpatients

BACKGROUND AND HYPOTHESIS: The robust evidence base supporting the therapeutic benefit of ketogenic diets in epilepsy and other neurological conditions suggests this same metabolic approach may also benefit psychiatric conditions. STUDY DESIGN: In this retrospective analysis of clinical care, 31 adu...

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Autores principales: Danan, Albert, Westman, Eric C., Saslow, Laura R., Ede, Georgia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9299263/
https://www.ncbi.nlm.nih.gov/pubmed/35873236
http://dx.doi.org/10.3389/fpsyt.2022.951376
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author Danan, Albert
Westman, Eric C.
Saslow, Laura R.
Ede, Georgia
author_facet Danan, Albert
Westman, Eric C.
Saslow, Laura R.
Ede, Georgia
author_sort Danan, Albert
collection PubMed
description BACKGROUND AND HYPOTHESIS: The robust evidence base supporting the therapeutic benefit of ketogenic diets in epilepsy and other neurological conditions suggests this same metabolic approach may also benefit psychiatric conditions. STUDY DESIGN: In this retrospective analysis of clinical care, 31 adults with severe, persistent mental illness (major depressive disorder, bipolar disorder, and schizoaffective disorder) whose symptoms were poorly controlled despite intensive psychiatric management were admitted to a psychiatric hospital and placed on a ketogenic diet restricted to a maximum of 20 grams of carbohydrate per day as an adjunct to conventional inpatient care. The duration of the intervention ranged from 6 to 248 days. STUDY RESULTS: Three patients were unable to adhere to the diet for >14 days and were excluded from the final analysis. Among included participants, means and standard deviations (SDs) improved for the Hamilton Depression Rating Scale scores from 25.4 (6.3) to 7.7 (4.2), P < 0.001 and the Montgomery-Åsberg Depression Rating Scale from 29.6 (7.8) to 10.1 (6.5), P < 0.001. Among the 10 patients with schizoaffective illness, mean (SD) of the Positive and Negative Syndrome Scale (PANSS) scores improved from 91.4 (15.3) to 49.3 (6.9), P < 0.001. Significant improvements were also observed in metabolic health measures including weight, blood pressure, blood glucose, and triglycerides. CONCLUSIONS: The administration of a ketogenic diet in this semi-controlled setting to patients with treatment-refractory mental illness was feasible, well-tolerated, and associated with significant and substantial improvements in depression and psychosis symptoms and multiple markers of metabolic health.
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spelling pubmed-92992632022-07-21 The Ketogenic Diet for Refractory Mental Illness: A Retrospective Analysis of 31 Inpatients Danan, Albert Westman, Eric C. Saslow, Laura R. Ede, Georgia Front Psychiatry Psychiatry BACKGROUND AND HYPOTHESIS: The robust evidence base supporting the therapeutic benefit of ketogenic diets in epilepsy and other neurological conditions suggests this same metabolic approach may also benefit psychiatric conditions. STUDY DESIGN: In this retrospective analysis of clinical care, 31 adults with severe, persistent mental illness (major depressive disorder, bipolar disorder, and schizoaffective disorder) whose symptoms were poorly controlled despite intensive psychiatric management were admitted to a psychiatric hospital and placed on a ketogenic diet restricted to a maximum of 20 grams of carbohydrate per day as an adjunct to conventional inpatient care. The duration of the intervention ranged from 6 to 248 days. STUDY RESULTS: Three patients were unable to adhere to the diet for >14 days and were excluded from the final analysis. Among included participants, means and standard deviations (SDs) improved for the Hamilton Depression Rating Scale scores from 25.4 (6.3) to 7.7 (4.2), P < 0.001 and the Montgomery-Åsberg Depression Rating Scale from 29.6 (7.8) to 10.1 (6.5), P < 0.001. Among the 10 patients with schizoaffective illness, mean (SD) of the Positive and Negative Syndrome Scale (PANSS) scores improved from 91.4 (15.3) to 49.3 (6.9), P < 0.001. Significant improvements were also observed in metabolic health measures including weight, blood pressure, blood glucose, and triglycerides. CONCLUSIONS: The administration of a ketogenic diet in this semi-controlled setting to patients with treatment-refractory mental illness was feasible, well-tolerated, and associated with significant and substantial improvements in depression and psychosis symptoms and multiple markers of metabolic health. Frontiers Media S.A. 2022-07-06 /pmc/articles/PMC9299263/ /pubmed/35873236 http://dx.doi.org/10.3389/fpsyt.2022.951376 Text en Copyright © 2022 Danan, Westman, Saslow and Ede. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Psychiatry
Danan, Albert
Westman, Eric C.
Saslow, Laura R.
Ede, Georgia
The Ketogenic Diet for Refractory Mental Illness: A Retrospective Analysis of 31 Inpatients
title The Ketogenic Diet for Refractory Mental Illness: A Retrospective Analysis of 31 Inpatients
title_full The Ketogenic Diet for Refractory Mental Illness: A Retrospective Analysis of 31 Inpatients
title_fullStr The Ketogenic Diet for Refractory Mental Illness: A Retrospective Analysis of 31 Inpatients
title_full_unstemmed The Ketogenic Diet for Refractory Mental Illness: A Retrospective Analysis of 31 Inpatients
title_short The Ketogenic Diet for Refractory Mental Illness: A Retrospective Analysis of 31 Inpatients
title_sort ketogenic diet for refractory mental illness: a retrospective analysis of 31 inpatients
topic Psychiatry
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9299263/
https://www.ncbi.nlm.nih.gov/pubmed/35873236
http://dx.doi.org/10.3389/fpsyt.2022.951376
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