Diet Drug Interactions: Achieving and Maintaining Ketosis As Adjunct to Psychotropic Polypharmacotherapy

As interest grows in the therapeutic potential of ketogenic diets for bipolar disorder, careful attention must be given to drug-diet interactions. Overlapping mechanisms between therapeutic ketosis and mood-stabilizing agents may offer opportunities for synergistic effects, but may also introduce risks related to altered pharmacokinetics, pharmacodynamics, and additive toxicities. In this podcast, Dina N. Ali, MD, and Jonathan Leung, PharmD, discuss the complex picture of trying to optimize treatment outcomes while many research questions are yet to be answered. Ali and Leung are authors of the commentary, "Diet Drug Interactions: Achieving and Maintaining Ketosis As Adjunct to Psychotropic Polypharmacotherapy," which is published in the November-December 2025 issue of the Journal of Clinical Psychopharmacology. The other contributing authors are Mark A. Frye, MD; Iain H. Campbell, PhD; Matej Markota, MD; Mikaela M. Hofer, PharmD, and Heather Standorf, PharmD. doi: 10.1097/JCP.0000000000002074