Is a ketogenic diet useful in the management of mood disorders?

The ketogenic diet (KD) has been proposed as a metabolic therapy and has attracted considerable interest as a potential adjunctive treatment for mood disorders (MDs). This narrative review highlights recent findings on the implementation of KD in MDs and critically evaluates the current evidence regarding its therapeutic use.

Randomized and prospective studies have strengthened the clinical evidence supporting KD, particularly for improving depressive symptoms when used as an adjunctive metabolic intervention. Potential adverse effects may occur, particularly in individuals with a healthy body weight or those lacking adequate nutritional knowledge to implement the diet appropriately.

Although recent findings are encouraging, additional adequately powered randomized controlled trials are needed before KD can be recommended for routine clinical practice in individuals with MDs. Lack of standardized criteria for defining and implementing KD across studies makes it difficult to synthesize the available evidence. Establishing expert consensus on KD protocols for research should be a priority and may represent the next step toward developing evidence-based clinical guidelines for the use of KD in psychiatry.