New results from first-of-its-kind randomized controlled trial on a ketogenic diet for schizophrenia and bipolar disorder with psychosis offer important insights into metabolic psychiatry and mental health treatment.

In this interview, Dr. Bret Scher sits down with Dr. Julie Milder to walk through the study results, recently published in Schizophrenia Bulletin. As the first RCT in psychosis-spectrum conditions to publish in the peer-reviewed literature, it’s an important step toward understanding how metabolic interventions may play a role in serious mental illness.

Key insights from the study:

In the 1-month randomized portion of the trial, the ketogenic group showed significant improvements in metabolic health markers compared to diet-as-usual Psychiatric symptoms trended toward improvement, but were not statistically significant at 1 month Participants who opted into the ketogenic extension part of the study (4 total months of keto), saw improvements in depression, cognition, and positive and negative symptoms.

In this video, Dr. Milder also breaks down important additional context about the limitations of the study, including the length of the randomized portion of the trial and the variance in dietary support between the two diet groups.

This study adds to growing evidence linking metabolic health and psychiatric conditions and explores whether ketogenic therapy may play a role in addressing underlying mechanisms.