Schizophrenia: Ketogenic Diet, Treatment & Remission, Psychology Today, NIH

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- PSYCHOLOGY TODAY. "Chronic Schizophrenia Put Into Remission Without Medication." New research suggests ketogenic diet may play a role in treating schizophrenia. By Chris Palmer, M.D. Apr 06, 2019. *Excerpts:

Schizophrenia is usually a chronic, devastating disorder that causes tremendous suffering. It can ruin lives. Even with the best treatments available, symptoms and suffering often continue. An article published April 6, 2019 in the medical journal Schizophrenia Research describes two patients with longstanding schizophrenia who experienced complete remission of symptoms with the ketogenic diet, a well-established, evidence-based treatment for epilepsy.
>Of particular interest, both patients were able to stop antipsychotic medications and have remained in remission for years now. Though more evidence is needed, this is extraordinarily hopeful news for those with this disorder and for the mental health professionals treating them.



The Psychotic Disorder Challenge. Schizophrenia affects 1 percent of the population. Its close cousin, bipolar disorder, affects 2-5 percent of the population. Tens of millions of people suffer. Why would the ketogenic diet help schizophrenia? The medical version of the ketogenic diet is a high-fat, low-carbohydrate, moderate-protein diet proven to work for epilepsy. In my article The Ketogenic Diet May Help Stop Seizures, I explain the history and research demonstrating that the ketogenic diet is a powerful intervention in treating epilepsy. While referred to as a “diet,” make no mistake: this is a powerful medical intervention.

Interestingly, the effects of this diet on the brain have been studied for decades because neurologists have been trying to figure out how it works in epilepsy. This diet is known to produce ketones which are used as a fuel source in place of glucose. This may help to provide fuel to insulin resistant brain cells. This diet is also known to affect a number of neurotransmitters and ion channels in the brain, improve metabolism, and decrease inflammation. So there is existing science to support why this diet might help schizophrenia.

But does it work? An 82 year old woman with chronic paranoid schizophrenia since age 17. The first patient documented in the Schizophrenia Research article is a woman who spent nearly her whole life suffering chronic, treatment-resistant schizophrenia. At the age of 70, weighing 330 pounds, she went to a medical weight loss clinic and was started on a ketogenic diet. Within two weeks of starting the diet, she reported a noticeable reduction not only in her weight but also her psychotic symptoms.
Within several months, she started to feel so much better that she was able to stop taking her psychiatric medications while remaining on the diet. Her case was first reported in 2009. Today, 12 years later, she has lost a total of 150 pounds and remains on the ketogenic diet.

Clearly more research is needed. However, make no mistake. All of these research findings, from the basic science of schizophrenia to the case reports and studies mentioned here, open up a new field of inquiry. ~ DISCLAIMER: Nothing in this article is intended as medical advice. - Author, Chris Palmer, M.D., is the director of the Department of Postgraduate and Continuing Education at McLean Hospital and an Assistant Professor of Psychiatry at Harvard Medical School.

MORE, https://www.psychologytoday.com/us/blog/advancing-psychiatry/201904/chronic-schizophrenia-put-remission-without-medication
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- NCBI. Med Hypotheses. 2018 Sept 18 4-77. doi: 10.1016/j.mehy.2018.06.022. Epub 2018 Jun 20. Ketogenic diet for schizophrenia: Nutritional approach to antipsychotic treatment. Włodarczyk A1, Wiglusz MS2, Cubała WJ2.

ABSTRACT. Schizophrenia is a mental disorder that mostly appears in the second or third decade of life with no consistent appearance. The first-line pharmacological treatment are antipsychotic drugs, which mainly act by suppressing the activity of dopamine. Unfortunately many of schizophrenic patients suffer from persistent positive or negative symptoms that cannot be fully treated with available medication. With exploration on the possible causes of the disease there is evidence on dopaminergic transmission defects, there is a need to find more holistic way in treating the disease and a diet regimen could be one of them.
Ketogenic diet, which is a popular diet regimen that consists in low-carbohydrate (about 30-50 g/day), medium-protein (up to 1 g/kg daily) and high-fat intake (around 80% of daily calories) mainly known for its helpful role in weight-loss. The key mechanism is to generate ketosis. A state in which ketones bodies in the blood provides energy part of the body's energy comes from ketone bodies in the blood. Possible hypothesis can be that ketogenic diet changes the ratio of GABA:glutamate in favor of GABA, by suppressing the catabolism and increasing the synthesis of GABA as well as glutamate metabolism, which could help to compensate the disrupted GABA levels in schizophrenic brain, leading to possible better outcome of the disease regarding symptomatology and preventing the weight-gain regarding some medications used and the correlating diseases responsible for weight gain. https://www.ncbi.nlm.nih.gov/pubmed/30037619

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1. Wheat and Schizophrenia, Psychology Today, 03/28/2011

https://www.psychologytoday.com/us/blog/evolutionary-psychiatry/201103/wheat-and-schizophrenia

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2. My mother might be alive today. We need data

not just case reports. If keto diet worked for a fraction of all schizophrenics it would relieve tremendous suffering.

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3. Indeed, this treatment could be life changing if widely proven.

Testing on a large scale should start asap, especially since the mentioned 1965 study using the same diet was dropped for some reason, and the the diet has also been used to help epileptics since the 1920s.

In the recent Reddit post of this, there are many comments and mixed views, one or two posters stating that relatives tried the diet but received no positive results.

https://www.reddit.com/r/psychology/comments/bag0v9/two_patients_with_longstanding_schizophrenia/

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4. Adherence to a regimented diet for someone suffering with Schizophrenia would be difficult.

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5. For purposes of a study, people who can't adhere to a diet

on their own based on professional assessment would receive additional help and monitoring. Beyond a clinical setting, some patients could manage on their own as with other activities of daily living-- personal care and tasks, especially if their symptoms abate and the condition improves-- or with additional support again. Adhering to the guidelines is the only way to benefit from nuitrition or most any therapy.