How Experts Recommend Using Ketogenic Therapy In Psychiatry (New Consensus)
Metabolic Mind
Contraindications and safety considerations
Georgia lists absolute and relative contraindications like inborn metabolic errors and cautions about SGLT2 inhibitors.
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:
- What a Delphi process is and why it was used
- The results of the Delphi process (33 consensus statements and 10 clinical recommendations)
- Who may be appropriate candidates for KMT
- Absolute and relative contraindications
- Recommended laboratory screening and monitoring
- How long a trial should last before assessing efficacy
- 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
- Harvard-Trained Psychiatrist
- https://www.diagnosisdiet.com/
Dr. Matthew Bernstein
Dr. Bret Scher
- Baszucki Group Medical Director
- https://x.com/bschermd
Resources Mentioned:
Awareness and Best Practices in using Ketogenic Therapy to Treat Serious Mental Illness: A Modified Delphi Consensus
Ketogenic Diets for Mental Health Clinician Training Course
Free CME Clinician Trainings:
Are you a clinician who would like to learn more about the science behind these therapies and how to implement them in practice? Earn CME with our growing library of courses from some of the top experts in the field including Dr. Chris Palmer, Dr. Georgia Ede, Dr. Matthew Bernstein, Dr. Mariela Glandt, Dr. Deanna Kelly, Dr. Julie Milder, Dr. Zoltan Sarnyai, and Dr. Bret Scher with more coming soon.
Our courses have been made FREE by grants from Baszucki Group, so we can spread these powerful therapies as widely as possible. Earn CME/CNE credits: https://www.metabolicmind.org/for-clinicians/trainings-courses/?utm_medium=organic-social&utm_source=youtube&utm_campaign=cme-yt
Follow our channel for more information and education from Bret Scher, MD, FACC, including interviews with leading experts in Metabolic Psychiatry.
Learn more about metabolic psychiatry and find helpful resources at https://metabolicmind.org/
About us:
Metabolic Mind is a non-profit initiative of Baszucki Group working to transform the study and treatment of mental disorders by exploring the connection between metabolism and brain health. We leverage the science of metabolic psychiatry and personal stories to offer education, community, and hope to people struggling with mental health challenges and those who care for them.
Our channel is for informational purposes only. We are not providing individual or group medical or healthcare advice nor establishing a provider-patient relationship. Many of the interventions we discuss can have dramatic or potentially dangerous effects if done without proper supervision. Consult your healthcare provider before changing your lifestyle or medications.
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