Harvard's New Keto for Bipolar Clinical Trial: A First Line Treatment?
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- Опубликовано: 9 июн 2024
- Learn about the design of a trail-blazing Randomized Controlled Trial (RCT) that will explore the physiology and biology of brain energy metabolism, while also informing clinical applications of ketogenic therapy as an adjunctive treatment option for patients with bipolar and schizophrenia spectrum disorders. RCTs are considered the gold standard when looking at the efficacy and safety of new treatment options. This type of research is necessary to understand whether ketogenic therapy should be offered as a first-line treatment option, as well as what types of strategies could increase accessibility of this intervention in the future. Dr. Bret Scher interviews principal investigators Dost Öngür, MD, PhD, and Dr. Virginie-Anne Chouinard, MD, about the details of this trial at McLean Hospital, a top-rated, Harvard-affiliated psychiatric hospital.
Learn more about the impressive design of this trial which includes a multidisciplinary approach to clinical care, gathering a variety of data to inform understanding of underlying brain energy mechanisms (including MRIs and metabolic markers), and an “open-label” approach that will allow the control group to opt into ketogenic therapy at the end of the first trial phase if desired.
Dr. Dost Öngür
William P. and Henry B. Test Professor of Psychiatry, Chief of the Division of Psychotic Disorders, & Director of the Schizophrenia and Bipolar Disorder Research Program at McLean Hospital
www.mcleanhospital.org/profil...
Dr. Virginie-Anne Chouinard,
Staff psychiatrist and Director of Research at McLean OnTrack™ & Instructor in Psychiatry at Harvard Medical School.
www.mcleanhospital.org/profil...
Press release about the trial:
www.prnewswire.com/news-relea...
For information on enrolling:
clinicaltrials.gov/study/NCT0...
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
2:03 Interest leading up to a keto for bipolar study
5:36 Brain energy metabolism and bipolar
7:44 Patient population for the new Harvard study
8:46 About the study
9:21 Dietary studies vs pharmacologic studies
11:55 The different interventions in the keto for bipolar study
14:42 What researchers will be looking at during the clinical trial
17:20 Balancing mechanism and clinical impact in research
19:21 Impact of the clinical trial
21:54 Working with a clinician for ketogenic therapy
25:30 Conclusion
#MetabolicMind
#KetoForMentalHealth
#MetabolicPsychiatry
#BipolarDisorder
#MetabolicNeuroscience
#KetogenicMetabolicTherapy
#NutritionalKetosis
#MentalIllness
#AlternativeTreatment
#Obesity
#MedicationSideEffects
#Schizophrenia
#SchizoaffectiveDisorder
#SchizophreniaSpectrumDisorders
Finally, a proper trial of keto for mental health. Long overdue
Look up change your diet change your mind too hearing the Psychiatrist from Harvard. Love her
Yes, Dr Ede is wonderful ❣
Also I had a friend tried 27 times and she did low carb keto she had cyclical Cushings disease and was mi's diagnosed w just PCOS. It was a game changer for her. She was misdiagnosed w bi polar when it was Cushings related
This is awesome. I think early intervention with the ketogenic diet could have a phenomenal affect. I wasn't accurately diagnosed for over 15yrs and didn't accidently put myself on the ketogenic diet for about another 7is years. That said my bipolar has still been extremely well controlled for over 8yrs now without medication, which is unheard of for me. However, I still have to work hard on other elements of my life in conjunction with the keto diet to keep it controlled (eg regular sleep routine, no alcohol, meditation exercise, sunlight etc). I suspect early intervention may make managing the condition easier long-term with or without medication as kindling doesn't get the chance to happen.
I have been working with very low carbohydrates/ketogenic diets for a long time. I used it to reverse metabolic syndrome before I knew others were doing it. I noticed the positive effects on mood and some of my patients.
Recently I was explaining the very low carbohydrate diet to a patient, a 77-year-old woman. When I got done explaining it to her and it was not the first time she had heard it she asked a simple question. Would it be OK if I just ate meat?
Nobody is carefully monitoring the metabolic disaster of people in the standard American diet. The only reason I can see to worry about going on a keto diet is that you may need a careful deprescribing.
In my experience with Bipolar (and possibly other psychiatric illness) a sudden drop in carbohydrates can trigger an episode. In my case hypomania. The problem with that is once triggered hypomania tends to be self propagating because one of the biggest triggers is not sleeping and when I'm hypomanic I can't sleep. I fell off the diet for a while and got the warning signs of an episode, so went to the doctor got the PRN but before I started taking it went keto cold turkey again. It did trigger worse hypomania, but was fine as it calmed down quite quickly once I got into ketosis and I had the PRN if it didn't. However, I'm quite perceptive to my symptoms and very disciplined at dealing with them early so it was relatively mild to start, I wouldn't like to assume that it would always calm down quickly every time or for everyone.
Kudos to the researchers. This is SO IMPORTANT. Looking forward to hearing the results.
Fantastic!! Thank you for your research.
Please do follow up on this, sounds great!
Thank you.
So interesting, I'll be closely watching this study :)
I am not a medical person but just read an article about amyloid plaques and their significance which seems now to be in question, so I think its great that people are looking at other modalities of tx for brain and memory problems. I do know that my grocery store has to work to keep adequately supplied with coconut milk in all its permutations.
Praying 🙏 for a miracle breakthrough!
May I ask why?
Of course, the major problem is that the average doctor has no idea and often no time to learn. So if you go to your Dr and say, hey, I’d like to try this keto diet thing you’ll very likely be told ‘don’t do that, diet has nothing to do with it, and keto will likely give you a heart attack anyway’.
Even relatively young endocrinologists will first tell diabetics what pills to take, remind them to get enough carbs as they are scared of a hypo and will add ‘try to eat less and move more’ as almost an afterthought.
yes big problem try meds first? yuck!
Do people have to live in the Boston area to be part of the study?
No, they don't. So even if someone is outside the area, it is worth contacting the team at McLean to see if they qualify for enrollment.
One more try...my comments keep vanishing. I'm looking for published research discussing the safety of being in a state of ketosis. A friend believes it is dangerous based on the research he finds. Thanks in advance for anyone that can help 🙏
Babies are born in ketosis. We are created to burn both BS and ketones. Ketones are as healthy if not preferred by our bodies.
@@BarbaraJ1111 Agreed! I shared that evidence and ask if he believes The Lord made a mistake. He replied that he doesn't believe in God, but happily follows the guidance of Ellen G. White when it comes to dietary choices (she took her nutritional advice directly from God).
We are interested in the research that demonstrates ketosis is dangerous. Ketosis is a normal, physiologic state. So, it seems that the burden is to prove it is harmful. Unfortunately, studies claiming low carb diets are 40% carbohydrates, or "keto-like diet" are 25% carbs, have nothing to do with ketosis and are misleading.
@licmind my comments were blocked when I tried to share the source, but maybe you can decipher in reverse??? org . facts nutrition
All I know is that we’ve been told that the ketogenic diet is the most studied diet ever - more than 100 studies. Also consider the Inuit who lived for thousands of years on meat ,fish, blubber and no carbs in the high North. They were incredibly healthy people. So much so, Queen’s University sent teams of students to the north to try to understand why they were “ immune” to cancer.
maybe KarXT and Keto Genic diet combined will be a game changer for SZ
What are the fat:protein:carb ratios used in these trials?
I'm looking for published research discussing the safety of being in a state of ketosis. A friend believes it is dangerous based on the research he finds. Thanks in advance for anyone that can help
From clinicaltrials.gov "The KD will consist of 3 meals a day plus snacks, targeting 75-80% fat, 13-18% protein, 7% carbohydrates." clinicaltrials.gov/study/NCT06221852
@@metabolicmind Bless you and thanks 🙏
@@metabolicmindseriously snacks are included? They are the first things that should be eliminated as well as having a long eating window. How can you get into ketosis, mitochondrial uncoupling and neurogenesis if you are eating all the time?
@@annburge291 The snacks are of course ketogenic. The amount of times you eat in a day does not impact your state of ketosis.
I’m within 7 years of my symptoms of BP2! Not medicated (tried that route - no good)
Diagnosed in 2023. Used ketosis to get out of my depressive episodes, but went back to SAD and was hypomanic.
Would love to be a part of this study!
Thank you for sharing your experience. You can visit clinicaltrials.gov/study/NCT06221852 to learn more about the study and possibly enrolling.
Thanks for sharing! How long did it take for you to see results from Ketosis?
@@henryzhao4622 I think it took like 3 weeks… may have been more of removing the bad food rather than getting to ketosis… I think everyone responds differently - certainly doing keto will help.
@@tby62 thanks so much - im one week in now so just trying to be patient bc its disrupting my sleep - im taking electrolytes, but i guess ill put the carbs before bed too instead of through theday
@@henryzhao4622 yeah it aint easy. Just stick to it and always focus on better foods… I’m still far from out of the woods but I’m improving on a weekly basis.
First lets determine who is funding this study as that may have the outcome already determined. I don't see an American dietician being unbiased enough to direct and monitor the ketogenic diet properly. I am hopeful as this could be a major break through.
Please make videos in Hindi language also🙏🙏🙏
I have a question: I developled bipolar in the last 2 years, and I am starting to realise that caffeine makes me feel really bad. Do you think one should avoid caffeine with bipolar?
That's a good question, but one where the answer is likely very individualized. It's really important to learn from our own personal experience and adjust accordingly.
Caffeine is Ok for me, but I do try to limit it anyway. I think everyone is different and reacts differently to all.
if it makes you feel bad then you already answered that question yourself ;) Caffeine is a very strong stimulant. If you've got a problem with this particular drug then why do you take it? You might have also take a too high dose. Srabuckscoffe for instance is super high. Or consume your caffeine portion from gren tea, that has other psychoactive stuff in it that modulates the caffeine to make you less jittery. And of course as with all stimulants: Magnesium!!!!!!
Would they ever accept a person who is in prison because of his bi-polar disorder?
Yes I have often wondered about birth control. The body is tricked into thinking its pregnant. A lot of women on BC automatically gain weight and end up with hypertension etc. Probably end up with meds to counteract the side effects of contraception. So at least on keto it can be trialled with a longer randalmised diet of 12 weeks.
Very happy that a trial is being undertaken. The approach isn't very scientific because it seems to be trying to prove an hypothesis. It would be more credible if they set out to prove that ketogenic diets aren't effective (maybe mitochondrial uncoupling is all that is needed). I'm a bit disappointed that newly diagnosed people aren't planned to be included that are only prescribed a ketogenic diet as the only treatment (no medication) as control B. I'd also like the type of ketogenic diet to be investigated...for example one that has more red meat, eggs, more saturated fat, cow's milk fermented dairy with green vegetables compared with a ketogenic diet that has more fish, poultry, goat's milk fermented dairy, eggs, olive oil, avocado, and green vegetables. And then a vegan version that is full of mitochondrial uncoupling foods such as green tea, chocolate, curcuma, ginger, MTC oil and slightly higher carbohydrate. I'd like the dietary intervention to last a year because the episodes of depression can last a few months and hypermania episodes can be twice a year. Twelve weeks is too short a time period because if the subject comes with seed oil toxicity, heavy metals and insulin resistance, it can take at least twelve weeks to stabilise.
We have some of those same ideas. One step at at a time. There are currently 12 clinical trials underway or completed for keto for serious mental illness. There is a listing on our website. And more on the way.
We just need some funding partners to take all this on! Several big philanthropies are interested, but it takes time. It would be nice if the NIH and NIMH stepped up.
Answer which is more dangerous? Going from a glucose based metabolism to a ketogenic state or visa versa.
We were meant to run primarily on ketones. You keep warning us not to go switch to the more natural state of ketogenisis without first hiring a doctorl. You suggest a possible manic reaction when switching to a ketogenic diet. But you have never given us the numbers. What happened in the Stanford study? I bet they had no trouble with anyone going ketogenic.
Is this simply just another case of doctors self-referring? I think it's only slightly more complicated.
Thanks for your comment. You are correct that there were no reported problems with mania in the Stanford study. As part of that study, they were closely monitored and worked very closely with their provider. Here's a video we did specifically about the risk of hypomania and ways to approach it. We hope you find it helpful. ruclips.net/video/F11ZBvCjVNk/видео.html
@@metabolicmind the video you suggested is good. While one should not discontinue seeing a medical professional at the outset of getting on a ketogenic diet, one should not hesitate to get on a ketogenic diet whether or not you have a medical professional already supervising you.
You repeatedly call it a "medical intervention" to get street credibility. (Though it of course involves chemicals, it's really better described as a proper diet.) , The problem in calling it a "medical intervention" is that you can't suggest people go it alone even though on the current state of knowledge that it is no more risky that encouraging a young person to engage in moderate exercise.
This is all more a comment on defects in the top-down-consensus approach we have to healthcare than the good and virtuous work you and this channel are doing. I pray you quickly receive the blessings and concensus from those at the top that you seek.
Looks like they are biased and putting the cart before the horse. Sad.
I wonder how many women with bipolar disorder have been on birth control for years.