Metabolic Therapies for Psychiatry: State of the Evidence
Metabolic Mind2 Maj 2023

Metabolic Therapies for Psychiatry: State of the Evidence

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.

#MetabolicMind

#KetoForMentalHealth

#MetabolicPsychiatry

#MetabolicNeuroscience

#KetogenicMetabolicTherapy

#NutritionalKetosis

#MentalIllnessTreatment

#MentalHealthIsMetabolicHealth

#BipolarDiet

#Science

Avsnitt(141)

Go Slowly: A Beginners Guide to Psychiatric Drug Tapering (Part 2)

Go Slowly: A Beginners Guide to Psychiatric Drug Tapering (Part 2)

Thinking about reducing or stopping psychiatric medication? It may not be the right approach for everyone, but for someone considering it, there's much to keep in mind.For instance, many individuals who adopt ketogenic therapy and other metabolic strategies often find themselves in need of reducing medication. But how can they do it safely and with minimal risk?In part 2 of our 2-part series on med tapering, Dr. Bret Scher and ‪@GeorgiaEdeMD‬ dive deep into how to safely and effectively taper psychiatric medications, offering guidance, caution, and hope for those exploring this path.Tapering antidepressants, antipsychotics, or mood stabilizers can be one of the most complex challenges in mental health care and it can come with serious risks. Dr. Ede breaks down what most clinicians miss about withdrawal, and why “slow and steady” isn’t just advice, it’s a necessity. She also explains how strategies like ketogenic therapy and other lifestyle interventions can support brain stability during the process.In this episode, you’ll learn:✅ Why individuals are looking to reduce or remove medication✅ The potential risks of not safely tapering✅ The “no sudden movements” rule and the concept of hyperbolic tapering✅ Tools and resources for safer dose reductions (compounding pharmacies, taper strips, and more)✅ How to increase your chances of feeling better with no or less medication✅ The role of metabolic health, nutrition, sleep, and stress management in effective tapering✅ What to do if your doctor is hesitant or resistant to adjusting your medication✅ Why you may want to consider avoiding supplementing during a taper🎥 To learn more about the importance of safe tapering and why it needs to be personalized, check out part 1 of this 2-part series: https://youtu.be/RVMvi-vU5E8Experts Featured:Dr. Bret ScherX: https://x.com/bschermdDr. Georgia EdeWebsite: https://www.diagnosisdiet.com/Book: https://www.diagnosisdiet.com/change-your-diet-change-your-mindYouTube: ‪@GeorgiaEdeMD‬X: https://xResources:The Maudsley Deprescribing Guidelineshttps://a.co/d/5WWskZsCrossing Zero: The Art and Science of Coming Off - and Staying Off - Psychiatric Drugshttps://www.amazon.com/dp/8797625906?Taper Clinichttps://taperclinic.com/Dr. Josef Witt-Doerring’s free Taper Clinic programhttps://taperclinic.com/our-program/Outro Healthhttps://www.outro.com/Free CME Clinician Trainings:Are you a clinician who would like to learn more about the science behind these therapies and how to implement them in practice? Earn CME with our growing library of courses from some of the top experts in the field including Dr. Chris Palmer, Dr. Georgia Ede, Dr. Matthew...

15 Okt 38min

Exposing the Truth Behind EAT-Lancet’s Diet Report & MisInfluencer Campaign

Exposing the Truth Behind EAT-Lancet’s Diet Report & MisInfluencer Campaign

The EAT-Lancet Commission recently released their updated "Planetary Health Diet" and preemptively labeled a number of health experts who pushed back as “mis-influencers.”Dr. Georgia Ede was one of those health experts labeled and in this episode of the Metabolic Mind podcast, she joins Dr. Bret Scher to unpack the many flaws of the EAT-Lancet 2.0 report.In this episode, you’ll learn about:The deep flaws in claiming a one-size-fits-all solution to diet and planetary health.EAT-Lancet’s heavy reliance on weak epidemiological dataIts open acknowledgment of nutrient deficiencies in the EAT-Lancet diet and who is most at riskWhy animal-sourced foods are beneficial for our health—especially for brain healthHow ideology and influence may be driving public health messagingDr. Ede’s response to being labeled a “mis-influencer”At Metabolic Mind, we believe optimal human nutrition begins with asking the right scientific questions—starting with what’s healthiest for the brain and body, then considering sustainable solutions.Human and planetary health are too complex for one-size-fits-all solutions—and if such a diet existed, we wouldn’t uncover it through untested epidemiological guesswork.Expert Featured:Dr. Georgia EdeWebsite: https://www.diagnosisdiet.com/Book: https://www.diagnosisdiet.com/change-your-diet-change-your-mindYouTube: ‪@GeorgiaEdeMD‬X: https://xResources MentionedEat LancetFree CME Clinician Trainings:Are you a clinician who would like to learn more about the science behind these therapies and how to implement them in practice? Earn CME with our growing library of courses from some of the top experts in the field including Dr. Chris Palmer, Dr. Georgia Ede, Dr. Matthew Bernstein and Dr. Bret Scher with more coming soon.Our courses have been made FREE by grants from Baszucki Group, so we can spread these powerful therapies as widely as possible. Earn CME/CNE credits:https://www.metabolicmind.org/for-clinicians/trainings-courses/?utm_medium=organic-social&utm_source=youtube&utm_campaign=cme-ytFollow 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 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.

13 Okt 39min

Taper Down Slowly: A Beginners Guide to Psychiatric Drug Tapering (Part 1)

Taper Down Slowly: A Beginners Guide to Psychiatric Drug Tapering (Part 1)

Psychiatric medications have become a standard of care for many mental illnesses. For some, these medications can be life-changing. For others, they may offer little relief, cause intolerable side effects, lose effectiveness over time, or even worsen symptoms.Regardless, many individuals eventually seek to reduce or discontinue psychiatric medication use—often without adequate support. Unfortunately, most clinicians receive limited training in how to guide patients through safe, personalized tapering protocols and the existing guidelines often fail to reflect real-world experiences.In part one of our new two-part series, Dr. Bret Scher and psychiatrist Dr. Georgia Ede delve into a critical yet under-discussed topic: how to taper psychiatric medications safely.In this episode, you’ll learn:Why people consider tapering (side effects, loss of benefit, life changes, etc.)Why safe psychiatric medication tapering is importantHow the brain adapts to meds (homeostasis) and how that impacts taper speedWhy personalization in medication management is importantHow to tell the difference between withdrawal and a true relapseHow to prepare: education, team support, and trusted resourcesAlmost everyone will need to adjust the dose of a medication at some point, even if only to try a different medication. Some will want to try to come off psychiatric meds entirely. It’s not a journey to take alone. Safe tapering is not a DIY process. We strongly encourage working with a knowledgeable healthcare provider who can help you personalize the approach, choosing the right pace, plan, and monitoring strategies to protect your health. In addition, we recommend resources below that can help.The goal isn’t simply to stop a medication, it’s to feel and function at your best. And the safest route is the one that’s tailored to you.📆 Stay tuned for episode 2 of our two-part series on psychiatric medication tapering—airing October 15.Expert Featured:Dr. Bret ScherX: https://x.com/bschermdDr. Georgia EdeWebsite: https://www.diagnosisdiet.com/Book: https://www.diagnosisdiet.com/change-your-diet-change-your-mindYouTube: ‪@GeorgiaEdeMD‬X: https://x.com/GeorgiaEdeMDIG: https://www.instagram.com/georgiaedemd/Resources Mentioned:Medication Tapering HubComing Soon! Sign up for our newsletter to be the first to know when new resources are available: https://www.metabolicmind.org/about-us/newsletter/The Maudsley Deprescribing Guidelineshttps://a.co/d/5WWskZsCrossing Zero: The Art and Science of Coming Off - and Staying Off - Psychiatric Drugshttps://www.amazon.com/dp/8797625906?Inner Compass Initiative<a...

8 Okt 41min

When low-carb isn’t enough: A Doctor’s Journey with GLP-1s

When low-carb isn’t enough: A Doctor’s Journey with GLP-1s

Ketogenic therapy is a powerful tool for weight loss. But not everyone who cuts carbs is able to achieve their goal weight and metabolic health goals. Could GLP-1s offer the missing piece when low-carb and clean eating aren’t quite enough?In this episode of the Metabolic Mind Podcast, Dr. Bret Scher sits down with Dr. Shannon Robinson, a board-certified psychiatrist and addiction medicine specialist, to explore this overlooked population who could benefit most from GLP-1s. Drawing from both her personal journey and clinical practice, Dr. Robinson highlights why lifestyle alone isn’t always enough, and how medications can sometimes be life-changing.In this conversation, you’ll learn:✅ Why GLP-1s may help patients already following strict low-carb or carnivore diets✅ How keto (and GLP-1s) are beneficial for weight loss and addiction✅ The parallels between GLP-1s and addiction medicine✅ Real-world insights on side effects, dosing, and the impact of GLP-1s on muscle✅ Advice for people starting GLP-1 medications✅ Why controlling GLP-1 dose is importantFor many, food and lifestyle changes unlock better health. But when life’s stressors and personal biology create roadblocks, other tools may be able to help. As Dr. Robinson highlights, GLP-1s aren’t a replacement for a healthy lifestyle, but when strategically used in combination with lifestyle changes, they can be a key to success for many people.👉Interested in learning more about metabolic health, ketogenic therapy, and lifestyle interventions for optimal mental health? Subscribe to Metabolic Mind for the latest research, expert interviews, and updates: https://www.youtube.com/@metabolicmind.#MetabolicMind #GLP1 #KetogenicTherapyExpert Featured:Dr. Shannon Robinsonhttps://www.linkedin.com/in/shannon-robinson-8aa3a4210/Free CME Clinician Trainings:Are you a clinician who would like to learn more about the science behind these therapies and how to implement them in practice? Earn CME with our growing library of courses from some of the top experts in the field including Dr. Chris Palmer, Dr. Georgia Ede, Dr. Matthew Bernstein and Dr. Bret Scher with more coming soon.Our courses have been made FREE by grants from Baszucki Group, so we can spread these powerful therapies as widely as possible. Earn CME/CNE credits:https://www.metabolicmind.org/for-clinicians/trainings-courses/?utm_medium=organic-social&utm_source=youtube&utm_campaign=cme-ytFollow 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 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...

6 Okt 32min

The Healing Depression Project: A New Path Beyond “Treatment Resistant” Depression

The Healing Depression Project: A New Path Beyond “Treatment Resistant” Depression

Depression that doesn’t improve, or gets labeled as treatment resistant, can leave people feeling without options and hopeless. But what if there was another way forward?In this interview, Dr. Bret Scher speaks with Silvia J. Covelli, founder and CEO of the Healing Depression Project, and Dr. Achina Stein, a board-certified psychiatrist and functional medicine physician. Together, they share how personal journeys and clinical insights converged to create a groundbreaking program that addresses depression at its root.You’ll hear Silvia’s story of living with depression for 25+ years before finding lasting relief through holistic lifestyle changes. And Dr. Stein explains how her own family’s health crisis led her to functional psychiatry.In this conversation, you’ll learn:How functional psychiatry focuses on metabolic, nutritional, and lifestyle drivers of mental health.What happens inside the Healing Depression Project retreats (labs, ketogenic therapy, , and community support).Why addressing lifestyle factors like sleep, diet, and movement can lead to depression remission, not just symptom management.How the Healing Depression Project is setting a new framework for what treating treatment resistant depression can look like.By combining functional psychiatry, metabolic therapies, and a compassionate community, this program is showing what metabolic psychiatry is all about: mental illness doesn’t always have to be a lifelong sentence.👉 Healing Depression Project is now accepting applications for their next retreat. Visit https://www.healingdepressionproject.com/ to learn more!Expert Featured:Silvia J. Covellihttps://www.linkedin.com/in/silvia-j-covelli-6709b0275/Dr. Achina SteinWebsite: https://fxnmind.com/dr-achina-stein/https://www.instagram.com/dr.achinastein/?hl=enResources Mentioned:Healing Depression Projecthttps://www.healingdepressionproject.com/Book: What If It’s Not Depression? Your Guide To Finding Answers and Solutionshttps://www.amazon.com/What-Its-NOT-Depression-Solutions/dp/B0BD4S9TDFFree CME Clinician Trainings:Are you a clinician who would like to learn more about the science behind these therapies and how to implement them in practice? Earn CME with our growing library of courses from some of the top experts in the field including Dr. Chris Palmer, Dr. Georgia Ede, Dr. Matthew Bernstein and Dr. Bret Scher with more coming soon.Our courses have been made FREE by grants from Baszucki Group, so we can spread these powerful therapies as widely as possible. Earn CME/CNE credits:https://www.metabolicmind.org/for-clinicians/trainings-courses/?utm_medium=organic-social&utm_source=youtube&utm_campaign=cme-ytFollow our channel for more information and education from Bret Scher, MD, FACC, including

1 Okt 50min

The Future of Mental Health Care: Training Doctors in Ketogenic Therapy

The Future of Mental Health Care: Training Doctors in Ketogenic Therapy

Ketogenic therapy for mental illness is gaining attention, with more and more patients looking to incorporate this strategy into their care plan.The problem is that sometimes patients struggle to find providers to help them and providers often lack the expertise and confidence to prescribe this strategy.These issues led to a light bulb moment for Dr. Kelly, “We’ve got to capacity build, we have to figure this out.”In this interview, Dr. Bret Scher speaks with Deanna Kelly, PharmD, internationally recognized for her work in schizophrenia, psychiatric pharmacology, and metabolic health, who is now pioneering an innovative project of her own called Live it, Launch it.This first-of-its-kind study is Dr. Kelly’s brainchild, designed to train clinicians through direct experience in an effort to increase clinical expertise in metabolic and ketogenic therapies. Participants don’t just learn the science, they actually live a ketogenic diet themselves, gaining confidence, competence, and practical insight to better guide patients struggling with psychiatric disorders.In this interview, you’ll discover:Why so many families are searching for trained ketogenic therapy cliniciansWhy personal experience may be the missing link in clinical adoptionThe potential widespread clinical impact of Live it, Launch it.The potential of ketogenic therapy alongside medications like GLP-1sAn update on Dr. Kelly’s in-patient ketogenic therapy for schizophrenia studyBy training clinicians to live it before they launch it, this study could change how psychiatric care is delivered, and help meet the growing demand for clinical guidance in ketogenic therapy.Expert Featured:Dr. Deanna KellyDirector of the Maryland Psychiatric Research CenterX: https://x.com/profdeannakResources Mentioned:Why Did the Maryland Health Department Halt a Critical Schizophrenia Study?https://youtu.be/tzPlQ6dJwe8Stanford Study Shows Promise of Ketohttps://www.metabolicmind.org/trials/featured/stanford-study-shows-promise-of-keto/Free CME Clinician Trainings:Are you a clinician who would like to learn more about the science behind these therapies and how to implement them in practice? Earn CME with our growing library of courses from some of the top experts in the field including Dr. Chris Palmer, Dr. Georgia Ede, Dr. Matthew Bernstein and Dr. Bret Scher with more coming soon.Our courses have been made FREE by grants from Baszucki Group, so we can spread these powerful therapies as widely as possible. Earn CME/CNE credits:https://www.metabolicmind.org/for-clinicians/trainings-courses/?utm_medium=organic-social&utm_source=youtube&utm_campaign=cme-ytFollow 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 non-profit initiative of...

29 Sep 29min

The 5 Lifestyle Habits That Make or Break College Mental Health

The 5 Lifestyle Habits That Make or Break College Mental Health

Dr. Ryan Patel, senior staff psychiatrist at The Ohio State University, shares a practical, evidence-based roadmap for helping young adults thrive during the most turbulent years of brain and behavior development.Across this deep dive, Dr. Patel explains why 18–24-year-olds are a distinct clinical population and how day-to-day habits can make or break academic performance, quality of life, and long-term health. He also discusses his work on the KIND Trial (Ketogenic Intervention in Depression) and how those results can help to inform care.In this conversation, Dr. Patel shares:Why college students require a different clinical lensAn overview of his five high-impact interventions: sleep, nutrient-dense nutrition, physical activity, mindful tech use, and stress managementHow lifestyle factors drive anxiety, depression, and dropout risk (and how to reverse course)Practical ways campuses and clinicians can scale preventionInsights from the KIND Trial: feasibility of ketosis in students and notable mood improvementsWhen and how to consider ketogenic therapy alongside standard care for depression👍 To learn more about metabolic health and mental well-being, subscribe to Metabolic Mind for more research, stories, and emerging evidence.👉For more information on the KIND study, checkout our blog: https://www.metabolicmind.org/resources/news-views/blog/perspectives-in-metabolic-psychiatry/kind-osu-keto-depression-study/👉Check out the Youth Mental Health Hub for even more information and resources: https://www.metabolicmind.org/resources/topics/youth-mental-health/Expert Featured:Dr. Ryan PatelBlog: https://u.osu.edu/emotionalfitness/Resources Mentioned:https://doi.org/10.1038/s41398-025-03544-8Free CME Clinician Trainings:Are you a clinician who would like to learn more about the science behind these therapies and how to implement them in practice? Earn CME with our growing library of courses from some of the top experts in the field including Dr. Chris Palmer, Dr. Georgia Ede, Dr. Matthew Bernstein and Dr. Bret Scher with more coming soon.Our courses have been made FREE by grants from Baszucki Group, so we can spread these powerful therapies as widely as possible. Earn CME/CNE credits:https://www.metabolicmind.org/for-clinicians/trainings-courses/?utm_medium=organic-social&utm_source=youtube&utm_campaign=cme-ytFollow 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 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...

22 Sep 51min

College Mental Health Crisis: How Students Can Combat Depression & Anxiety

College Mental Health Crisis: How Students Can Combat Depression & Anxiety

Are there new treatment options for college students living with depression?Mental health challenges are rising at an alarming rate among young people—and college campuses are feeling the impact. Nearly half of students report depressive symptoms, and conventional treatments aren’t enough for many of them.But what if just changing what you eat could offer new hope?A recent pilot study out of The Ohio State University found that a ketogenic diet led to rapid and clinically significant improvements in depression symptoms among college students—with a 37% average reduction in depression scores in just two weeks, increasing to a 71% increase at 12 weeks.In this conversation, lead study investigator Drew Decker sits down with Drs. Georgia Ede and Bret Scher to discuss how his group was able to help 100% of completing participants experience clinically significant improvements in depression and the real-world feasibility of implementing ketogenic therapy in student populations.In this episode you’ll hear about:The current state of mental health on college campusesThe factors contributing to the decline in youth mental healthThe potential of ketogenic therapy for major depressive disorderHow OSU students were able to stay in ketosis 73% of the timeWhat colleges can do to better support mental wellness through nutritionStudents are searching for better options and they deserve more than just symptom management. They deserve access to therapies that could improve their quality of life and transform their futures.To learn more about the KIND study, check out our other content:Mini-Documentary: https://youtu.be/RZYjV9bo0SIDr. Volek & Decker Interview: https://youtu.be/kN0kHPVM3lwBlog Post: https://www.metabolicmind.org/resources/news-views/blog/perspectives-in-metabolic-psychiatry/new-research-a-ketogenic-diet-improved-depression-in-college-students/Experts Featured:Drew Decker, OSU researcherInstagram: https://www.instagram.com/drew_d_decker/Dr. Georgia Ede, MDWebsite: https://www.diagnosisdiet.com/Book: https://www.diagnosisdiet.com/change-your-diet-change-your-mindYouTube: ‪@GeorgiaEdeMD‬X: https://x.com/GeorgiaEdeMDIG: https://www.instagram.com/georgiaedemd/Resources Mentionedhttps://doi.org/10.1038/s41398-025-03544-8Free CME Clinician Trainings:Are you a clinician who would like to learn more about the science behind these therapies and how to implement them in practice? Earn CME with our growing library of courses from some of the top experts in the field including Dr. Chris...

15 Sep 38min

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