by Dost Öngür

I recently co-chaired a meeting of experts in neuroscience, psychiatry, and metabolism at the Ernst Strüngmann Forum in Frankfurt, Germany. At that meeting, we explored how disruptions in brain energy metabolism—particularly involving mitochondrial function, oxidative phosphorylation, and glycolysis—may contribute to the development and persistence of psychiatric disorders such as schizophrenia, bipolar disorder, and depression. We share some of our discussions in this perspectives piece in Nature Mental Health.

Multiple lines of evidence suggest that individuals with psychiatric disorders exhibit bioenergetic abnormalities, including a shift toward aerobic glycolysis (similar to the Warburg effect in cancer), which may impair neural circuits and exacerbate symptoms. These metabolic imbalances are thought to affect neurotransmission, redox biology, and insulin signaling, potentially leading to cognitive deficits and neuroinflammation. To develop more effective and tolerable treatments, we need a deeper understanding of these processes

To address this challenge, in our paper we propose a research agenda aimed at advancing the emerging field of metabolic neuropsychiatry. We start by underscoring the importance of identifying biomarkers and refining experimental paradigms to guide future studies. These advances can deepen our insights into the implications of metabolic dysfunction for information processing and psychiatric symptom formation in the brain. We next advocate for therapeutic strategies that target improving brain metabolism, including potential pharmacological interventions as well as non-pharmacological approaches such as the ketogenic diet. The ultimate goal is to improve outcomes and quality of life for individuals affected by mental illness using these innovative approaches.

Dost Öngür is the Chief of the Psychotic Disorders Division at McLean Hospital and William P. and Henry B. Test Professor of Psychiatry at Harvard Medical School.

Learn more in the original perspective article:
Brain and body energy metabolism and potential for treatment of psychiatric disorders
Andreazza, A.C., Barros, L.F., Behnke, A. et al.  Nat. Mental Health 3, 763–771 (2025).