Ketogenic Diets in Neurology, Psychiatry, and Addiction Medicine

"The ketogenic diet (KD) is unique in improving symptoms for many conditions, from epilepsy to addiction, according to a recent JAMA Psychiatry article. It's a high-fat, very-low-carbohydrate nutritional therapy that shifts the body's from glucose dependence to ketone production as the primary fuel source. Increasing evidence implicates metabolic dysfunction, neuroinflammation, and neurotransmitter imbalance in psychiatric and addictive disorders-domains directly influenced by ketosis."

"Formulated in the 1920s by Dr. Russell Wilder at the Mayo Clinic to mimic the effects of fasting as a treatment for epilepsy, the ketogenic diet replicates the biochemical effects of fasting through carbohydrate restriction. Such restriction creates a metabolic state called ketosis that helps control seizures. Wilder's KD provided a 4:1 ratio of fat to carbohydrate and protein (80% fat, 15% protein, 5% carbohydrates)."

"The diet also helps people with alcohol use disorder (AUD). Acute alcohol intake shifts brain energetics from glucose to acetate, an alcohol metabolite. In individuals with AUD, low brain glucose and high acetate metabolism persist beyond acute intoxication. This nutritional state may contribute to alcohol withdrawal signs and symptoms, as well as to alcohol craving, and relapses. The KD reduces neural hyperexcitability and oxidative stress, abetting detoxification."

The ketogenic diet (KD) is a high-fat, very-low-carbohydrate therapy that shifts the body's primary fuel from glucose to ketone production. Formulated in the 1920s by Dr. Russell Wilder to mimic fasting, the KD uses a 4:1 fat-to-carbohydrate-and-protein ratio to induce ketosis for seizure control. Inducing ketosis improved anticonvulsant outcomes, allowed adequate nutrition, and prompted a 1990s resurgence for intractable pediatric epilepsy. KD is an established therapy for drug-resistant epilepsy, with seizure reductions exceeding 50% in many patients. The diet also aids alcohol use disorder by correcting persistent low brain glucose and high acetate metabolism, reducing neural hyperexcitability and oxidative stress to support detoxification. Interest in KD extends to psychiatry because metabolic dysfunction, neuroinflammation, and neurotransmitter imbalance appear central to several major mental illnesses.

Read at Psychology Today