Uploaded July 2026 | Updated September 2026, 16 seconds ago
New results from first-of-its-kind randomized controlled trial on a ketogenic diet for schizophrenia and bipolar disorder with psychosis offer important insights into metabolic psychiatry and mental health treatment.
In this interview, Dr. Bret Scher sits down with Dr. Julie Milder to walk through the study results, recently published in _Schizophrenia Bulletin._ As the first RCT in psychosis-spectrum conditions to publish in the peer-reviewed literature, it’s an important step toward understanding how metabolic interventions may play a role in serious mental illness.
Key insights from the study:
- In the 1-month randomized portion of the trial, the ketogenic group showed significant improvements in metabolic health markers compared to diet-as-usual
- Psychiatric symptoms trended toward improvement, but were not statistically significant at 1 month
- Participants who opted into the ketogenic extension part of the study (4 total months of keto), saw improvements in depression, cognition, and positive and negative symptoms.
In this video, Dr. Milder also breaks down important additional context about the limitations of the study, including the length of the randomized portion of the trial and the variance in dietary support between the two diet groups.
This study adds to growing evidence linking metabolic health and psychiatric conditions and explores whether ketogenic therapy may play a role in addressing underlying mechanisms.
👉 Want to learn more about the trial? Visit our study page: metmind.co/4pcxsna
🔎 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. Julie Milder
- Baszucki Group Director of Neuroscience
- linkedin.com/in/juliemilder
Dr. Bret Scher
- Baszucki Group Medical Director
- https://x.com/bschermd
*Resources Mentioned*
*Metabolic improvements with a ketogenic diet correlate with symptom improvement in psychosis: A randomized controlled trial*
- doi.org/10.1093/schbul/sbag082
*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:
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 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.
*Timestamps:*
0:00 - Introduction: First RCT of Keto for Psychosis: Schizophrenia, Bipolar, & Schizoaffective Disorder
1:17 - Study Design Explained: 1-Month RCT (With NIH Grant) Keto Diet Vs. Diet As Usual
3:47 - Why 4 Weeks Isn’t Enough: Lessons in Trial Design + 4 Month Extension
6:10 - Early Results from 1-Month RCT: Metabolic Improvements on Keto + Positive Trends in Psychiatric Symptoms
8:00 - 4-Month Extension: Psychiatric Outcomes/ Symptoms Actually Improve
8:55 - Positive vs Negative Symptoms: Why This Matters for Treatment
9:45 - Is This a “Negative Trial”? How to Interpret the Results
11:15 - Rapid Responders vs Average Outcomes: Real-World vs Trials
13:15 - Cognitive Function in Psychosis: A Major Treatment Gap
15:55 - Future Research: 12–14 Week RCTs & What’s Coming Next
18:00 - Final Takeaway: Ketogenic Therapy’s Potential for Serious Mental Illness
New results from first-of-its-kind randomized controlled trial on a ketogenic diet for schizophrenia and bipolar disorder with psychosis offer important insights into metabolic psychiatry and mental health treatment.
In this interview, Dr. Bret Scher sits down with Dr. Julie Milder to walk through the study results, recently published in _Schizophrenia Bulletin._ As the first RCT in psychosis-spectrum conditions to publish in the peer-reviewed literature, it’s an important step toward understanding how metabolic interventions may play a role in serious mental illness.
Key insights from the study:
- In the 1-month randomized portion of the trial, the ketogenic group showed significant improvements in metabolic health markers compared to diet-as-usual
- Psychiatric symptoms trended toward improvement, but were not statistically significant at 1 month
- Participants who opted into the ketogenic extension part of the study (4 total months of keto), saw improvements in depression, cognition, and positive and negative symptoms.
In this video, Dr. Milder also breaks down important additional context about the limitations of the study, including the length of the randomized portion of the trial and the variance in dietary support between the two diet groups.
This study adds to growing evidence linking metabolic health and psychiatric conditions and explores whether ketogenic therapy may play a role in addressing underlying mechanisms.
👉 Want to learn more about the trial? Visit our study page: metmind.co/4pcxsna
🔎 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. Julie Milder
- Baszucki Group Director of Neuroscience
- linkedin.com/in/juliemilder
Dr. Bret Scher
- Baszucki Group Medical Director
- https://x.com/bschermd
*Resources Mentioned*
*Metabolic improvements with a ketogenic diet correlate with symptom improvement in psychosis: A randomized controlled trial*
- doi.org/10.1093/schbul/sbag082
*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:
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 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.
*Timestamps:*
0:00 - Introduction: First RCT of Keto for Psychosis: Schizophrenia, Bipolar, & Schizoaffective Disorder
1:17 - Study Design Explained: 1-Month RCT (With NIH Grant) Keto Diet Vs. Diet As Usual
3:47 - Why 4 Weeks Isn’t Enough: Lessons in Trial Design + 4 Month Extension
6:10 - Early Results from 1-Month RCT: Metabolic Improvements on Keto + Positive Trends in Psychiatric Symptoms
8:00 - 4-Month Extension: Psychiatric Outcomes/ Symptoms Actually Improve
8:55 - Positive vs Negative Symptoms: Why This Matters for Treatment
9:45 - Is This a “Negative Trial”? How to Interpret the Results
11:15 - Rapid Responders vs Average Outcomes: Real-World vs Trials
13:15 - Cognitive Function in Psychosis: A Major Treatment Gap
15:55 - Future Research: 12–14 Week RCTs & What’s Coming Next
18:00 - Final Takeaway: Ketogenic Therapy’s Potential for Serious Mental Illness
