Therapeutic
My care team consisted of professionals I had been already working with (a psychiatrist, GP, psychotherapist) as well as a team of online dietitians specializing in keto. I was on aripiprazole when I started. My tapering model was inspired by Dr Mark Horowitz’s hyperbolic approach. I had already been reducing the dose for 3 years before keto (from 7.5 mg through 5, to 3.75). While on keto, I went to 2.5 four months into the diet, 1.25 a year into, 0.6 five months later, and 0.3 two months after that. I kept this dose for 2 more months (it involved cutting a 5 mg tablet into 16 pieces) and crossed zero in January 2025 – a year and a half after starting keto.
Integration
I followed a Mediterranean keto diet of 3000 kcal/day. Example macros for 1 day: 132 g of proteins, 254 g of fats, 52 g of net carbs. I didn’t feel the need to go lower on carbs as I was satisfied with the results, and my dietitian reassured me that even higher carb values are effective in epilepsy treatments given MCT supplementation.
Nutritional
I did a comprehensive bloodwork at the onset, including OGTT. I do blood testing every 6 months to monitor lipid levels, liver, and kidneys. I checked ketone levels with Keto-Diastix, which game me sufficient idea on what worked and what needed adjusting in terms of food choices. I also used a smartwatch to track my fluid intake, before I developed an intuitive grasp on proper hydration.
Ketosis
I eat 5 meals a day. The initial supplementation plan included vitamins D and B, alpha-lipoic acid, berberine, and an omega 3-6-9 oil mix: linseed, evening primrose, borage, blackcurrant, rosemary. Most importantly, an electrolytes powder. My current mainstay are the electrolytes, citrates/lemon juice, and periodical vitamin D.
