Pilot study of a ketogenic diet in bipolar disorder

Needham, N. et al. (2023) Pilot study of a ketogenic diet in bipolar disorder. BJPsych Open, 9, e176. (doi: 10.1192/bjo.2023.568) (PMID:37814952) (PMCID:PMC10594182)

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.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Bahuguna, Dr Pankaj and Rigby, Dr Benjamin and McIntosh, Professor Emma and Simpson, Professor Sharon
• Authors: Needham, N., Campbell, I. H., Grossi, H., Kamenska, I., Rigby, B. P., Simpson, S. A., McIntosh, E., Bahuguna, P., Meadowcroft, B., Creasy, F., Mitchell-Grigorjeva, M., Norrie, J., Gibbs, M. C., McLellan, A., Fisher, C., Moses, T., Burgess, K., Brown, R., Thrippleton, M., Campbell, H., and Smith, D. J.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Health Economics and Health Technology Assessment; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU
• Journal Name: BJPsych Open
• Publisher: Cambridge University Press
• ISSN: 2056-4724
• ISSN (Online): 2056-4724
• Copyright Holders: Copyright © TheAuthor(s) 2023
• First Published: First published in BJPsych Open 9:e176
• Publisher Policy: Reproduced under a creative commons licence

Project Code	Award No	Project Name	Principal Investigator	Funder's Name	Funder Ref	Lead Dept
304823001	1	Complexity in health	Sharon Simpson	Medical Research Council (MRC)	MC_UU_00022/1	HW - MRC/CSO Social and Public Health Sciences Unit