Carbohydrate Reward and Psychosis: An Explanation For Neuroleptic Induced Weight Gain and Path to Improved Mental Health?

Evidence links dopamine release in the mid-brain to the pathophysiology of psychosis, addiction and reward. Repeated ingestion of refined carbohydrate may stimulate the same mesolimbic dopaminergic pathway, rewarding such eating behaviour and resulting in excessive food intake along with obesity. In this paper, we explore the role of dopamine in reward and psychosis, and discuss how reward pathways may contribute to the weight gain that commonly follows antipsychotic drug use, in people with psychotic illness. Our theory also explains the frequent co-occurrence of substance abuse and psychosis. From our hypothesis, we discuss the use of carbohydrate modified diets as an adjunctive treatment for people with psychosis.