Episode Details

Ketogenic therapy for schizophrenia, bipolar disorder, and depression is gaining attention, but how can it be safely implemented into clinical practice?

A newly published expert consensus provides practical recommendations to help clinicians thoughtfully apply ketogenic metabolic therapy (KMT) for serious mental illnesses.

In this in-depth conversation, Dr. Matt Bernstein and Dr. Georgia Ede, both members of the expert committee, discuss how this Delphi consensus was developed, what it includes, and how it can be responsibly integrated into psychiatric practice.

In this interview, they discuss:

1. What a Delphi process is and why it was used
2. The results of the Delphi process (33 consensus statements and 10 clinical recommendations)
3. Who may be appropriate candidates for KMT
4. Absolute and relative contraindications
5. Recommended laboratory screening and monitoring
6. How long a trial should last before assessing efficacy
7. How clinicians can personalize implementation safely

Importantly, the authors emphasize that ketogenic metabolic therapy is not a replacement for standard psychiatric treatment. Rather, it may be considered alongside first-line therapies, particularly for individuals who have not responded adequately, cannot tolerate medications, or are seeking additional options.

Reflecting on the value of this work, Dr. Bernstein shares:

“I would have loved to have read this six years ago when I was starting to think about implementing these types of practices. It would have given me confidence to charge forward… I probably would have been further along now than I am.”

With randomized controlled trials ongoing and more research expected in the coming years, this consensus provides a thoughtful, experience-informed framework for clinicians who are seeing growing interest in metabolic approaches.

If you are a clinician, we encourage you to read the full publication.

If you are a patient or family member, consider sharing this interview and the paper with your care team to support an informed discussion about whether metabolic strategies may be appropriate in your individual case.

As always, clinical decisions should be made in partnership with qualified healthcare professionals.

📚 Read the Paper: Published in Frontiers in Nutrition: https://doi.org/10.3389/fnut.2026.1749406

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

Expert Featured:

Dr. Georgia Ede

1. Harvard-Trained Psychiatrist
2. https://www.diagnosisdiet.com/

Dr. Matthew Bernstein

1. CEO of Accord: https://accordmh.com/