Evolution of Medicine Podcast · Functional Forum

Metabolic Psychiatry: Healing the Brain

February 2, 2026·36 min·2 clips

Chris Palmer’s lecture on ketogenic diets reversed treatment-resistant psychosis in a patient on Clozapine.

1. Evolution of Medicine Podcast focuses on metabolic psychiatry and Dr. Matt Bernstein’s work with ketogenic diets for brain health. 2. Host Dr. James Maskell interviews Dr. Matt Bernstein, a psychiatrist at Ellenhorn and founder of ACCORD, a metabolic psychiatry program outside Boston. 3. The episode asks whether metabolic interventions can become a standard of care for mental health and cognitive decline. 4. Bernstein says two of his three sons developed abrupt neuroinflammation at ages 12 and 14, with mental health symptoms and cognitive symptoms that left them unable to read. 5. He says traditional mental health treatment did not help and, in his account, made the boys worse before a PANS diagnosis clarified the picture. 6. He explains that PANS is pediatric acute neuropsychiatric syndrome, related to PANDAS and often connected to strep infections, autoimmune encephalitis, other infections, or toxins. 7. Bernstein says the family eventually found practitioners who could help with infections, toxins, and supportive brain care. 8. He says the experience forced him to reconsider a psychiatric model that focused on neurotransmitters without a deep medical workup. 9. He describes hearing Chris Palmer at McLean talk about reversing treatment-resistant psychotic disorders with ketogenic diets. 10. Bernstein recounts a patient on Clozapine whose psychosis reversed after a few months on a ketogenic diet and who remained non-psychotic for the next 10 years. 11. He says that lecture made him think ketogenic therapy could be a powerful tool for mental health and brain health. 12. He says he began by talking one by one with outpatients, starting with low glycemic eating, then fasting, then MCT oil. 13. Bernstein says patients often returned saying, “my brain turned on,” after making those dietary changes. 14. He explains that he later brought the approach into Ellenhorn, a psychosocial rehabilitation program, but found it was not immersive enough for everyone. 15. He says ACCORD was created about a year and a half ago to combine ketogenic diet support, a dietitian, a chef, exercise, mindfulness, and circadian rhythm work. 16. Bernstein says people come from locally, from across the United States, and from other countries to do the program for one to three months. 17. He says psychiatric medication interventions can improve symptoms, but he has not seen them fully restore functioning the way metabolic treatment sometimes can. 18. Bernstein argues that ketogenic diet supports neurons, glial cells, the liver, the immune system, and detoxification pathways at the same time. 19. He says the interview was held two weeks after the new food pyramid, and he notes that the guidelines now mention very low carbohydrate diets for chronic health conditions. 20. He says the next phase for ACCORD may include a second location and a less intensive model for people who want a slower version of the program.

As heard by us

A focused case for metabolic psychiatry that links diet, brain health, and a wider move toward standard care.

The episode builds a steady case for metabolic psychiatry, treating depression, bipolar disorder, schizophrenia, OCD, and ADHD as different faces of a shared brain problem. It gives ketogenic diets a credible role as an adjunct to psychiatric care and follows Dr.

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Why you'd press play

If you want psychiatry framed through metabolism instead of symptom suppression.

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