Q:  Ketogenic Diet & Bipolar Disorder

I read somewhere (your site?) that there are theories that bipolar disorder is some form of seizures too deep in the brain to record with current measures, which may explain the response to seizure meds. 

I knew a child once with seizures that did not respond to medication but had good results with the ketogenic diet.  Is there any evvidence this is an option of any sort for bipolars?

Dear M' -- 
Hmm, shoulda thought of that myself.  Hadn't.  So, go off and search (PUB MED, "ketogenic bipolar disorder"); sure enough, somebody else has thought of that too.  Dr. El-Mallakh from the University of Louisville, Kentucky (a very nice fellow, who spontaneously gave me a ride in his station wagon at the last Bipolar conference in Pittsburgh when I was looking a bit lost) wrote in 2001: 

The ketogenic diet, originally introduced in the 1920s, has been undergoing a recent resurgence as an adjunctive treatment for refractory epilepsy, particularly in children. In this difficult-to-treat population, the diet exhibits remarkable efficacy with two-thirds showing significant reduction in seizure frequency and one-third becoming nearly seizure-free. There are several reasons to suspect that the ketogenic diet may also have utility as a mood stabilizer in bipolar illness. These include the observation that several anticonvulsant interventions may improve outcome in mood disorders. Furthermore, beneficial changes in brain-energy profile are noted in subjects on the ketogenic diet. This is important since global cerebral hypometabolism is a characteristic of the brains of depressed or manic individuals. Finally, the extracellular changes that occur in ketosis would be expected to decrease intracellular sodium concentrations, a common property of all effective mood stabilizers. Trials of the ketogenic diet in relapse prevention of bipolar mood episodes are warranted.

In other words, he proposes the same theory as yours, and gives a few reasons it might really work -- but by his account, it had not been studied at that time.  Since then, the only other citation on PUB MED is a letter from Dr. Belmaker in Israel.  I just wrote for a copy and he replied he'll have one sent this coming week.  I'll ask the folks at Bipolar World to help me post a follow-up on this subject and send you a copy.  

Dr. Phelps
 

Published March, 2004