Randomized Clinical Trial of a Ketogenic Diet for Treatment-Resistant Depression Published in JAMA Psychiatry

This peer-reviewed randomized clinical trial, published in JAMA Psychiatry, evaluated a six-week ketogenic diet intervention in adults living with treatment-resistant depression.

Participants were randomly assigned to one of two dietary interventions:

• Ketogenic diet: A carbohydrate-restricted diet (fewer than 30 grams per day) supported with prepared foods and structured coaching to help participants achieve nutritional ketosis.
• Plant-rich control diet: A comparator diet encouraging increased fruit and vegetable intake and replacing saturated fats with unsaturated plant-based oils, matched for the frequency of support.

The interventions were delivered remotely with weekly dietetic support. No serious adverse events were reported during the study.

Both dietary groups experienced substantial reductions in depression symptoms, with the ketogenic diet slightly outperforming the control group at 6 weeks. Improvements were not consistently observed across secondary measures such as anxiety or anhedonia.

After the six-week intervention period ended, most participants did not continue their assigned diet. Regardless of diet continuation, average depression scores remained improved compared to baseline in both groups at the 12-week follow-up.

Overall, this study offers a cautious positive signal and contributes to the growing body of evidence in the emerging field of metabolic psychiatry. Larger and longer trials can help identify who benefits most and determine what levels of support make ketogenic therapy practical in real-world settings.