Episode Details

The second-ever pilot trial (published in the Journal of Affective Disorders) is making waves: a virtual medically supervised ketogenic diet showed impressive improvements in people with moderate to severe depression, including nearly 7 out of 8 study completers achieving clinical remission.

In this interview, Dr. Bret Scher sits down with lead researcher Dr. Elisa Brietzke, Professor of Psychiatry at Queen’s University, to explore the inspiration, execution, and implications of this study.

What began as a bold idea, that metabolic dysfunction plays a role in depression, evolved into a fully remote clinical intervention. Despite skepticism and challenges, the results were clear: ketogenic therapy can be safely and effectively implemented in a remote outpatient setting. Participants who completed the study experienced improvements in depression, anxiety, and anhedonia (the loss of pleasure).

In this conversation, Dr. Brietzke shares:

1. Why she turned to metabolic therapy for mental health
2. How the team pulled off a fully remote ketogenic trial during the pandemic
3. The science behind how inflammation, insulin resistance, and brain energy affect mood
4. Why traditional antidepressants often fail to address anhedonia
5. What’s next for research, and how this could shape depression treatment guidelines

👉 If you or someone you know is struggling with treatment-resistant depression, learn more about metabolic therapies on our Depression Topic Page: https://www.metabolicmind.org/resources/topics/keto-for-depression/

🔎 Have questions about how to apply metabolic therapies effectively? Submit them at metabolicmind.org/questions to be featured in a future Metabolic Mailbag episode.

#MetabolicMind #KetogenicTherapy #FoodAsMedicine #Depression #Anhedonia

Expert Featured:

Dr. Elisa Brietzke

1. https://psychiatry.queensu.ca/news/welcome-dr-elisa-brietzke
2. https://www.linkedin.com/in/elisa-brietzke-844606281/?originalSubdomain=ca
3. https://www.instagram.com/dr.elisabrietzke/
4. https://x.com/@e_brietzke

Resources Mentioned:

Medically supervised ketogenic diet as an adjunctive treatment for moderate to severe depression: A pilot study

1. https://doi.org/10.1016/j.jad.2025.121079

Free CME Clinician Trainings:

Are you a clinician who would like to learn more