Episode Details

Can ketogenic therapy help offset some of the metabolic side effects of clozapine while preserving its psychiatric benefits?

Dr. Deanna Kelly, a leading clozapine researcher, joins Dr. Bret Scher to discuss what she has seen clinically when ketogenic therapy is used alongside clozapine and other antipsychotic medications.

Dr. Kelly shares the case of a patient taking clozapine who also had diabetes and metabolic syndrome. After five weeks on a ketogenic diet, the patient’s glucose, insulin, and hemoglobin A1C returned to the normal range. She also explains why people taking antipsychotics such as clozapine or olanzapine may have a harder time reaching ketosis and why careful monitoring matters.

They discuss:

• Using ketogenic therapy alongside clozapine
• Metabolic side effects associated with antipsychotic treatment
• Why ketosis may be harder to achieve on clozapine or olanzapine
• Changes in clozapine blood levels that may occur with ketogenic therapy
• Why lower clozapine levels do not automatically mean the dose should be increased
• The possibility of gradually reducing antipsychotic doses once someone is stable
• Why Dr. Kelly views dose reduction through a harm-reduction lens
• The importance of expert clinical supervision when adjusting psychiatric medications

The research in this area is still limited, but Dr. Kelly believes there is real promise in exploring whether ketogenic therapy can help reduce metabolic burden and, in some cases, support lower antipsychotic doses without sacrificing psychiatric stability.

Medication safety is critical. Clozapine and other psychiatric medications should only be adjusted with experienced clinical supervision, especially when starting ketogenic therapy, because medication levels and effects can change as metabolism changes.

💡 Learn more about the importance of clinical support with psych meds and how ketogenic therapy may impact medication needs and dosage on our Keto and Psych Meds Topic Page: www.metabolicmind.org/resources/topics/keto-and-psych-meds/.

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

#Clozapine #KetogenicTherapy #MetabolicPsychiatry

Expert Featured:

Dr. Deanna L. Kelly

• https://www.metabolicmind.org/team/deanna-kelly-pharmd-bcpp/
• https://x.com/ProfDeannaK
• https://www.instagram.com/dr.deanna.kelly/
• https://www.linkedin.com/in/deanna-l-kelly-pharmd-bcpp-3a8b299b/?isSelfProfile=false

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