The effects of the ketogenic diet on psychiatric symptomatology, weight and metabolic dysfunction in schizophrenia patients

Abstract

Objective: The authors aimed to test the effect of a therapeutic ketogenic diet (KD) on the psychotic condition, body composition and metabolic dysfunction in schizophrenic patients, as well as to report the compliance with the diet.Method: Two Ecuadorian schizophrenic patients' male and female (twins) aged 22, were included in a six-week controlled-blinded pilot study under the therapeutic KD. Compliance was determined by daily urine measurements (commercially available ketone strips). Body composition was analyzed using bio-impedance (Tanita SC-331S) and the clinical outcomes were assessed by blood, urine and electrocardiogram analysis. The psychiatry condition was evaluated by the PANSS scale and, a two weeks follow-up after intervention was conducted to evaluate patients' health condition.Results: During intervention, after ~15 days of ketosis, PANSS scores decreased in both female (97 to 91) and male (82 to 75) patients. Body fat decreased from 24.5% to 19.8% and 21.7% to 16.8%, respectively. Interestingly, after the third week of the intervention, male patient' liver enzymes were downregulated to normal levels (AST=0-40 U/L & ALT=0-41 U/L). No other significant clinical outcomes were observed during the study. Of relevance, both patients broke the KD in several occasions. Conclusions:The present research showed that a short-time ketogenic diet (KD) has positive effects in the psychiatric condition, metabolic dysfunction and body composition of young schizophrenia patients; suggesting the need of a clinical trial to corroborate its use as a co-treatment.

Measurement of lactate levels in postmortem brain, iPSCs, and animal models of schizophrenia

“…Further, impaired prepulse inhibition (PPI) of the startle response (a translationally validated endophenotype of schizophrenia) in the MK-801 NMDA hypofunction model was prevented following ketogenic diet 37 . There have also been case studies suggesting ketogenic diet may be an effective treatment for positive and negative symptoms in schizophrenia and schizoaffective disorder, as well as metabolic dysfunction 38 , 39 . In conclusion, accumulating evidence suggests increases in lactate could be a pathological indicator of bioenergetic defects in cognitive disorders including schizophrenia.…”

The relationship between the diet, microelements, macronutrients and vitamins on the schizophrenia – literature analysis

“…This could lead to a possible better disease outcome in reducing symptoms and preventing weight gain with some medications used. The effectiveness of the use of the ketogenic diet on young people at this time was demonstrated, for example, in the case report from Ecuador [16], where in two patients treated for schizophrenia (twins, a woman and a man) after dieting, a reduction in both the PANSS and BMI values in both patients and normalization of liver enzymes in a man. In addition, postmortem studies of the prefrontal cortex and the results of in vivo NMR spectroscopy have shown that there is a bioenergetic dysfunction characterized by abnormal glucose processing and mitochondrial dysfunction, which results in impaired synaptic communication in the brain of people with schizophrenia [17].…”

Ketogenic Therapy in Serious Mental Illness: Emerging Evidence

“…More rigorous and longer term case studies have been conducted ( Table 2 ) in different populations by one of us (C.M.P.) and have provided encouraging results both in terms of symptom control and safety/tolerability ( Palmer, 2017 , 2019b ; Gilbert-Jaramillo et al, 2018 ), which we summarized recently ( Sarnyai et al, 2019 ).…”