How Experts Recommend Using Ketogenic Therapy In Psychiatry (New Consensus)

Ketogenic therapy for schizophrenia, bipolar disorder, and depression is gaining attention, but how can it be safely implemented into clinical practice? A newly published expert consensus provides practical recommendations to help clinicians thoughtfully apply ketogenic metabolic therapy (KMT) for serious mental illnesses. In this in-depth conversation, Dr. Matt Bernstein and Dr. Georgia Ede, both members of the expert committee, discuss how this Delphi consensus was developed, what it includes, and how it can be responsibly integrated into psychiatric practice. In this interview, they discuss: What a Delphi process is and why it was used The results of the Delphi process (33 consensus statements and 10 clinical recommendations) Who may be appropriate candidates for KMT Absolute and relative contraindications Recommended laboratory screening and monitoring How long a trial should last before assessing efficacy How clinicians can personalize implementation safely Importantly, the authors emphasize that ketogenic metabolic therapy is not a replacement for standard psychiatric treatment. Rather, it may be considered alongside first-line therapies, particularly for individuals who have not responded adequately, cannot tolerate medications, or are seeking additional options. Reflecting on the value of this work, Dr. Bernstein shares: “I would have loved to have read this six years ago when I was starting to think about implementing these types of practices. It would have given me confidence to charge forward… I probably would have been further along now than I am.” With randomized controlled trials ongoing and more research expected in the coming years, this consensus provides a thoughtful, experience-informed framework for clinicians who are seeing growing interest in metabolic approaches. If you are a clinician, we encourage you to read the full publication. If you are a patient or family member, consider sharing this interview and the paper with your care team to support an informed discussion about whether metabolic strategies may be appropriate in your individual case. As always, clinical decisions should be made in partnership with qualified healthcare professionals. 📚 Read the Paper: Published in Frontiers in Nutrition: https://doi.org/10.3389/fnut.2026.174... 🔎 Have questions about how to apply metabolic therapies effectively? Submit them at https://metabolicmind.org/questions to be featured in a future Metabolic Mailbag episode. Expert Featured: Dr. Georgia Ede Harvard-Trained Psychiatrist https://www.diagnosisdiet.com/ Dr. Matthew Bernstein CEO of Accord: https://accordmh.com/   / matthew-bernstein-5743338   Dr. Bret Scher Baszucki Group Medical Director https://x.com/bschermd Resources Mentioned: Awareness and Best Practices in using Ketogenic Therapy to Treat Serious Mental Illness: A Modified Delphi Consensus https://doi.org/10.3389/fnut.2026.174... Ketogenic Diets for Mental Health Clinician Training Course https://www.diagnosisdiet.com/training 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: https://www.metabolicmind.org/for-cli... 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 https://metabolicmind.org/ Timestamps: 0:00 - Introduction to Dr. Georgia Ede and Dr. Matt Bernstein and their role in this new Delphi paper in Frontiers In Nutrition. 2:10 - What is a Delphi process? Who does it benefit? 4:48 - Who were the experts involved in creating this Delphi consensus paper? 7:00 - How does Dr. Bernstein see this consensus paper impacting physicians? 8:55 - Of the 10 consensus recommendations from the paper, which are the most impactful? 11:57 - Was there any difficulty getting consensus on the 33 statements that were agreed on? How did the group handle the disagreements? 17:45 - Was medication management addressed in the Delphi paper? 18:44 - Did the group define who should and should not be considered for ketogenic therapy? 22:05 - What information did the expert group give about monitoring guidelines? 23:28 - Final thoughts and where to learn more.