Navigation
A ketogenic diet for treatment-resistant depression: a randomized clinical trial
The exploration of dietary interventions for mental health has gained traction, particularly in managing conditions like treatment-resistant depression (TRD). This study aims to assess the effectiveness of a ketogenic diet (KD) compared with a control diet in this patient population.
Conducted between February 22 and June 15, 2024, the randomized controlled trial included 88 adults aged 18 to 65 years from the UK, all diagnosed with TRD and scoring 15 or higher on the 9-item Patient Health Questionnaire (PHQ-9). Participants were equally divided, receiving either a KD with less than 30 g of carbohydrates daily and personalized dietetic support, or a control diet emphasizing phytochemical intake, allowing one extra serving of fruits or vegetables, with dietetic assistance. Follow-up assessments were conducted at a 12-week mark.
The primary outcome was change in PHQ-9 scores from baseline to week 6, while secondary measures assessed remission rates, anxiety levels, cognitive function, and overall quality of life. Results indicated significant reductions in depression severity in both dietary groups. The KD group reported a mean change in PHQ-9 score of -10.5 (SD, 7.0), while the phyto group showed a mean change of -8.3 (SD, 5.1). The calculated mean difference in PHQ-9 scores at 6 weeks was -2.18 (95% CI, -4.33 to -0.03; P = .05; Cohen d, -0.68), and at 12 weeks, it was -1.85 (95% CI, -4.04 to 0.33; P = .10; Cohen d, -0.58). Despite these findings, no significant differences appeared across secondary outcomes, and no serious adverse events were reported.
In conclusion, while the KD demonstrated some antidepressant effects over the control diet at 6 weeks, the modest effect size raises questions about its clinical significance. Further research is warranted to explore the broader implications of dietary interventions in managing TRD. [NPID: Ketogenic diet, depression, randomized clinical trial, carbohydrates]
Year: 2026
