March 7, 2022 Depression is an important public health problem that is associated with significant personal and societal costs. Despite several different therapeutic modalities available for the treatment of depression, such as antidepressants, psychotherapies and neuromodulation, a significant number of patients do not respond well or do not tolerate current treatments.In addition to established risk factors such as genetic vulnerability, trauma, chronic stress, substance use and medical diseases, recent research has pointed out the relevance of dietary patterns in the incidence and persistence of depressive symptoms in children, adolescents, adults and the elderly. People exposed to highly processed diets with high carbohydrate and saturated fat content and low consumption of fresh food and vegetables are at higher risk of developing major depressive disorder. These findings are in line with research on the role of inflammation and oxidative stress in the pathophysiology of depression. A few trials have investigated the use of dietary interventions to treat people with depression with promising results. Treatment guidelines are starting to acknowledge the importance of promoting lifestyle changes as an important initial step for all patients with mood and anxiety disorders.One of the promising nutritional interventions is the ketogenic diet. It is a high fat, low carbohydrate diet that changes the energy metabolism and lead to the use of ketone bodies as the primary source of energy. In the brain, this diet may have mood stabilizing properties through altered signaling of neurotransmitters dopamine, GABA, and glutamate, as well as more effective ATP production. It has been used for more than a century as an effective treatment for refractory epilepsy and there are multiple studies being conducted in a number of brain-based diseases such as brain cancer, Alzheimer’s disease and autism spectrum disorders.Researchers at the Neuromood Lab - a CNS affiliated research lab led by Dr. Elisa Brietzke, Professor of Psychiatry at Queen’s University - are investigating the therapeutic effect of the safety of the ketogenic diet in persons with major depressive disorder who did not respond to a class of antidepressants called serotonin selective reuptake inhibitors (SSRIs). Participants will continue on their current antidepressant and a will prescribe the ketogenic diet as an adjunctive treatment for 12 weeks. Patients will report on their mood and anxiety symptoms as will be monitored for side effects and metabolic changes such as glucose and serum lipids. The group is also interested in the effect of the ketogenic diet in women experiencing depressive symptoms related to the menopause transition. Dr. Fabiano Gomes, Assistant professor of Psychiatry at Queen’s University and co-leader of the Neuromood Lab, is responsible for this study and was awarded a BBRF/NARSAD Young Investigator Grant to fund the study.Studies are being conducted predominantly online with limited in person assessments. If you are interested in knowing more about this research or in participating in the studies, please send an email to keto@queensu.ca.
