Impact of a Ketogenic Diet on Metabolic and Psychiatric Health in Patients With Bipolar or Schizophrenia Illness

Inclusion Criteria:

   1. Age 18-75 years old

   2. Meet DSM V criteria for schizophrenia or bipolar disorder, any subtype, for > 1 year
   and clinically stable (with no hospitalization for past 3 months)

   3. Currently taking psychotropic medication and gained at least 5% weight since starting
   medication or have a BMI greater than or equal to 26 kg/m2 or presence of at least one
   metabolic abnormality (hypertriglyceridemia, insulin resistance, dyslipidemia,
   impaired glucose tolerance)

   4. Willing to consent to all study procedures and attend follow-up appointments and
   motivated to follow the dietary program.

   5. Sufficient control over their food intake to adhere to study diets.

   6. Willingness to regularly monitor blood pressure, glucose, dietary intake, and body
   weight over the 4-month trial

Exclusion Criteria:

   1. Any subject pregnant or nursing

   2. Comorbidity of developmental delay

   3. Active substance abuse with illicit drugs or alcohol

   4. In a current severe mood or psychotic state when entering the study that would
   prohibit compliance with study visits or dietary program.

   5. Anyone who has been hospitalized or taken clozapine over the past 3 months

   6. Inability to complete baseline measurements

   7. Severe renal or hepatic insufficiency

   8. Cardiovascular dysfunction, including diagnosis of:

      1. Congestive heart failure

      2. Angina

      3. Arrhythmias

      4. Cardiomyopathy

      5. Valvular heart disease

   9. Any other medical condition that may make either diet dangerous as determined by the
   study medical team (e.g. anorexia nervosa)