Abstract
Background Key underlying metabolic pathologies are thought to play a role in bipolar disorder (BD), including dysfunctions in energy metabolism. This review highlights underlying metabolic mechanisms of BD and potential therapeutic effects of a low carbohydrate ketogenic diet (KD) on mood symptoms. Based on its robust effectiveness in treating epilepsy, the KD has garnered recent interest in its application for mood disorders as it may imitate the pharmacological effects of mood stabilizers, commonly prescribed agents in the treatment of both BD and epilepsy, amongst other effects on stabilizing neural networks in the brain.
Methods A literature review was conducted on current metabolic mechanisms of BD and clinical developments in KD.
Results Recent findings support the idea that BD may have roots of metabolic dysfunction: cerebral glucose hypometabolism, oxidative stress, as well as mitochondrial and neurotransmitter dysfunction. A KD provides alternative fuel to the brain and is believed to contain beneficial neuroprotective effects, including neural network stabilization and inflammation reduction. Several beneficial metabolic effects on insulin resistance, weight, and lipid composition have been shown.
Limitations Limited case studies on KD treatment in BD have been reported to date.