Clinical Trial Suggests Ketogenic Diet May Benefit Patients With Psychotic Disorders

Could changing what you eat help improve serious mental illnesses? A new clinical trial suggests a ketogenic diet may benefit both the body and the brain in people with schizophrenia and bipolar disorder.

Published in Schizophrenia Bulletin, the first-of-its-kind randomized controlled trial by researchers at the University of California, San Francisco (UCSF) evaluated the effects of a ketogenic diet in people with schizophrenia-spectrum or bipolar I disorders. The study, partly funded by the U.S. National Institute of Mental Health (NIMH), enrolled 58 participants, with 47 completing the initial one-month comparison between a ketogenic diet and a usual diet. Twenty-five participants then continued the ketogenic diet for an additional four months.

The researchers found the diet was both feasible and well tolerated. During the first month, 83% of participants maintained nutritional ketosis, increasing to 94% during the extension phase, with no significant side effects reported.

After just one month, participants following the ketogenic diet showed significant improvements in key metabolic health markers compared with the control group. Higher ketone levels were linked to lower blood glucose levels and reduced depression scores, even after accounting for weight loss, suggesting that ketosis itself may contribute to the benefits.

Participants who continued the diet for four months experienced sustained metabolic improvements alongside meaningful reductions in depression and schizophrenia symptoms. They also demonstrated better cognitive performance, indicating potential benefits beyond physical health.

However, the authors caution that the four-month results came from a small, single-arm extension and require confirmation in larger, longer, fully controlled clinical trials. They conclude that while the findings are promising, more research is needed before ketogenic therapy can be recommended as a standard treatment for serious mental illnesses.

REFERENCE: Abram, S. V., et al. (2026) Metabolic improvements with a ketogenic diet correlate with symptom improvement in psychosis: A randomized controlled trial. Schizophrenia Bulletin. DOI: 10.1093/schbul/sbag082. https://academic.oup.com/schizophreniabulletin/article-abstract/52/4/sbag082/8725541