Prolonged water fasting also treated seizures effectively long before this, but you’ll die if you do it forever, so the Mayo Clinic invented the ketogenic diet in 1929 as a way to achieve the same effect while keeping someone well fed.
The keto diet works by raising GABA levels in the brain but doesn’t *force* synaptic GABA effects like the drugs do, so it didn’t make people as zombified as phenobarbital, a barbiturate, the then-leading treatment for seizures.
Mayo invented the keto diet as an alternative to phenobarbital.
In the 1970s barbiturates were largely replaced with benzodiazepines, which have a lower side effect profile, have a lower risk of fatal overdose, and are less zombifying.
Big Pharma got the keto diet reclassified as for “refractory epilepsy” meaning it is the last resort when all the drugs fail, but that is not why it was invented.
Keto diets likely have broad efficacy where fasting and GABAergic drugs have efficacy.
They have downsides and limitations and not everyone is a good candidate for them but they are profoundly under-utilized in psychiatry.
In the 1950s, Yuri Nikolaev, a Russian psychiatrist, started treating mentally ill patients with prolonged water fasting.
He went on to treat over 8,000 people. Reports suggest that over 70% of patients showed significant improvement, with many returning to normal functioning and work.
Nikolaev’s work was documented by Western doctors, such as Dr. Allan Cott, who visited the Soviet Union to study these methods and later published findings that hailed the results as an "unparalleled achievement".