{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T22:04:08Z","timestamp":1791583448436,"version":"4.3.4"},"reference-count":32,"publisher":"Royal College of Psychiatrists","issue":"6","license":[{"start":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T00:00:00Z","timestamp":1696896000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["BJPsych open"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:sec id=\"S2056472423005689_sec_a1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Recent evidence from case reports suggests that a ketogenic diet may be effective for bipolar disorder. However, no clinical trials have been conducted to date.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472423005689_sec_a2\">\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To assess the recruitment and feasibility of a ketogenic diet intervention in bipolar disorder.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472423005689_sec_a3\" sec-type=\"methods\">\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Euthymic individuals with bipolar disorder were recruited to a 6\u20138 week trial of a modified ketogenic diet, and a range of clinical, economic and functional outcome measures were assessed. Study registration number: ISRCTN61613198.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472423005689_sec_a4\" sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 27 recruited participants, 26 commenced and 20 completed the modified ketogenic diet for 6\u20138 weeks. The outcomes data-set was 95% complete for daily ketone measures, 95% complete for daily glucose measures and 95% complete for daily ecological momentary assessment of symptoms during the intervention period. Mean daily blood ketone readings were 1.3 mmol\/L (s.d. = 0.77, median = 1.1) during the intervention period, and 91% of all readings indicated ketosis, suggesting a high degree of adherence to the diet. Over 91% of daily blood glucose readings were within normal range, with 9% indicating mild hypoglycaemia. Eleven minor adverse events were recorded, including fatigue, constipation, drowsiness and hunger. One serious adverse event was reported (euglycemic ketoacidosis in a participant taking SGLT2-inhibitor medication).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472423005689_sec_a5\" sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The recruitment and retention of euthymic individuals with bipolar disorder to a 6\u20138 week ketogenic diet intervention was feasible, with high completion rates for outcome measures. The majority of participants reached and maintained ketosis, and adverse events were generally mild and modifiable. A future randomised controlled trial is now warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1192\/bjo.2023.568","type":"journal-article","created":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T05:55:42Z","timestamp":1696917342000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":60,"title":["Pilot study of a ketogenic diet in bipolar disorder"],"prefix":"10.1192","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3610-1669","authenticated-orcid":false,"given":"Nicole","family":"Needham","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iain H.","family":"Campbell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Grossi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivana","family":"Kamenska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin P.","family":"Rigby","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon A.","family":"Simpson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"McIntosh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pankaj","family":"Bahuguna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben","family":"Meadowcroft","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frances","family":"Creasy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maja","family":"Mitchell-Grigorjeva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Norrie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerard","family":"Thompson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa C.","family":"Gibbs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ailsa","family":"McLellan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheryl","family":"Fisher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tessa","family":"Moses","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl","family":"Burgess","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Brown","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Thrippleton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6169-6262","authenticated-orcid":false,"given":"Harry","family":"Campbell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2267-1951","authenticated-orcid":false,"given":"Daniel J.","family":"Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2023,10,10]]},"reference":[{"key":"S2056472423005689_ref27","doi-asserted-by":"publisher","DOI":"10.1017\/jns.2020.46"},{"key":"S2056472423005689_ref25","doi-asserted-by":"publisher","DOI":"10.1002\/mds.27390"},{"key":"S2056472423005689_ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2019.03.019"},{"key":"S2056472423005689_ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.mehy.2020.110299"},{"key":"S2056472423005689_ref9","first-page":"CD001903","article-title":"Ketogenic diets for drug-resistant epilepsy","volume":"11","author":"Martin-McGill","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"S2056472423005689_ref18","unstructured":"18 EuroQol Research Foundation. 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