ArticleBJPsych open2023
Pilot study of a ketogenic diet in bipolar disorder.
Article in BJPsych open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
38 citing papers in PubMed, 1 synthesis or guideline pooled it, 49 citations in OpenAlex.
- Adverse events and tolerability of ketogenic diets - a systematic literature analysis.BMC nutrition · 2026Pooled it
- Transcriptomic Analysis of the Amygdala in Subjects with Schizophrenia, Bipolar Disorder and Major Depressive Disorder Reveals Differentially Altered Metabolic Pathways.Schizophrenia bulletin · 2026Article
- Dietetic Prescriptions in Bipolar Disorder: Nutritional Strategies to Support Mood Stability and Reduce Relapse Risk-A Narrative Review.Life (Basel, Switzerland) · 2026Review
- Ketosis as a Treatment for Severe Mental Illness: A Critical Review of Preclinical and Clinical Data.Current treatment options in psychiatry · 2026Review
- Participant food tracking in psychiatric ketogenic metabolic therapy: an unresolved clinical, psychosocial, and implementation question.Frontiers in nutrition · 2026Review
- Cognitive behavioral therapy for bipolar disorder: patient-level participation barriers and ketogenic metabolic therapy as a candidate adjunct.Frontiers in psychology · 2026Review
- Reconceptualizing bipolar disorder through an integrative biological lens: synthesis, convergence, and emerging directions.Frontiers in integrative neuroscience · 2026Review
- Hypomanic symptoms and first manic episode during ketogenic diet treatment in a patient taking venlafaxine: a case report with longitudinal glucose-ketone index and clinical monitoring.Frontiers in nutrition · 2026Article
- Ketogenic therapy as a potential novel treatment approach for PTSD: an integrative review and proposed mechanistic model.Frontiers in psychiatry · 2026Review
- Clinical Insights Into the Mechanistic Crossroads of Lamotrigine and Therapeutic Ketosis in Bipolar Depression.Biological psychiatry global open science · 2026Review
- A retrospective evaluation of an online group ketogenic metabolic therapy intervention on mental health outcomes.Frontiers in nutrition · 2026Article
- From Food to Mood: Psychological and Psychiatric Impact of Diet in Bipolar Disorder.Nutrients · 2025Review
- A pilot study examining a ketogenic diet as an adjunct therapy in college students with major depressive disorder.Translational psychiatry · 2025Article
- Circadian rhythms in metabolism and mental health: a reciprocal regulatory network with implications for metabolic and neuropsychiatric disorders.Current opinion in physiology · 2025Review
- Review
- Longitudinal Data From the KETO-CTA Study: Plaque Predicts Plaque, ApoB Does Not.JACC. Advances · 2025Article
- The ketogenic diet and metabolic treatments for neuropsychiatric disorders.BJPsych open · 2025Article
- A pilot study of a ketogenic diet in bipolar disorder: clinical, metabolic and magnetic resonance spectroscopy findings.BJPsych open · 2025Article
- Pilot study of a ketogenic diet in bipolar disorder: a process evaluation.BMC psychiatry · 2025Article
- Remission of OCD and ulcerative colitis with a ketogenic diet: Case Report.Frontiers in psychiatry · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
22 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundRecent evidence from case reports suggests that a ketogenic diet may be effective for bipolar disorder. However, no clinical trials have been conducted to date.
aimsTo assess the recruitment and feasibility of a ketogenic diet intervention in bipolar disorder.
methodEuthymic 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.
resultsOf 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).
conclusionsThe 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.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.