Metabolic Therapies for Psychiatry: State of the Evidence

6 snips

May 2, 2023

Guest

Shebani Sethi

Guest

Cynthia Calkin

Dr. Shebani Sethi, a psychiatrist at Stanford specializing in metabolic mental health, and Dr. Cynthia Calkin from Dalhousie, an expert in psychiatric therapies, dive into the fascinating link between metabolic health and mental illness. They discuss how therapies like nutritional ketosis and metformin might alleviate severe psychiatric symptoms. The conversation highlights the significance of robust clinical trials and shares insights on how these findings can impact real-world patient care, especially for those seeking alternative treatment options.

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INSIGHT

Ketones as Superior Brain Fuel

Ketones provide roughly 30% more energy to the brain than glucose, making them a more efficient fuel.
Ketogenic diets impact mitochondrial activity, immune function, inflammation, oxidative stress, and neurotransmitter levels.

INSIGHT

Metabolic Dysfunction Precedes Mental Illness

Metabolic dysfunction and insulin resistance precede many psychiatric disorders such as schizophrenia and bipolar disorder.
Abnormal glucose and insulin signaling is evident even before medications are started in first-episode psychosis.

ANECDOTE

Pilot Study Yields Promising Results

In a pilot study, patients on keto showed 25% less depression and 39% less anxiety.
Improvements also included 23% better quality of life, reduced inflammation, and 11% weight loss over 4 months.

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Metabolic health is strongly connected to mental health, and metabolic therapies, like nutritional ketosis, or the insulin-sensitizing medication metformin, can improve psychiatric symptoms or even put them into remission. But how strong is the evidence connecting metabolic and mental health? Stanford psychiatrist Dr. Shebani Sethi and Dalhousie psychiatrist Dr. Cynthia Calkin help us explore the state of the evidence. And importantly, they help put the evidence into perspective. For instance, what level of evidence do you need if you are a prescribing psychiatrist versus a mom desperate for help for her child? Drs. Sethi and Calkin conduct research in this area and are experienced clinicians treating patients regularly. This combination gives them the insight to help us better understand the state of the evidence.

Experts featured in this video:

Shebani Sethi, MD. Clinical Assistant Professor in Psychiatry and Behavioral Sciences and Director of the Metabolic Psychiatry Clinic at Stanford University. https://metabolicpsychiatry.com/stanford-affiliates Twitter @ShebaniMD

Cynthia Calkin, MD. Associate Professor in Psychiatry and Medical Neurosciences at Dalhousie University. https://medicine.dal.ca/departments/department-sites/psychiatry/our-people/faculty/cynthia-calkin.html

Academic papers referenced in this video:

Treating Insulin Resistance With Metformin as a Strategy to Improve Clinical Outcomes in Treatment-Resistant Bipolar Depression (the TRIO-BD Study): A Randomized, Quadruple-Masked, Placebo-Controlled Clinical Trial https://pubmed.ncbi.nlm.nih.gov/35120288/

The relationship between bipolar disorder and type 2 diabetes: more than just co-morbid disorders https://pubmed.ncbi.nlm.nih.gov/22621171/

The Role of Ketogenic Metabolic Therapy on the Brain in Serious Mental Illness: A Review https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9728807/

Table of Contents:

0:00 - Introduction

2:11 - Interview with Dr. Shebani Sethi

11:42 - Interview with Dr. Cynthia Calkin

15:23 - Continuing Interviews

32:41 - Conclusion

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/

About us:

Metabolic Mind™ is a nonprofit initiative incubated by Baszucki Group. Our mission is to provide education and resources in the emerging field of metabolic psychiatry, including ketogenic interventions for mental disorders.

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.

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