Researchers reviewed 25 years of studies on a special ketogenic formula called KetoCal that helps people with hard-to-treat epilepsy. This high-fat, low-carb drink has been used since the 1920s alongside ketogenic diets to reduce seizures when regular medications don’t work. The review of 41 studies found that people who used this formula along with their ketogenic diet had fewer seizures, stuck to their treatment better, and found it easier to follow than diet alone. The formula was safe with no serious side effects, and both patients and families liked how it tasted and how convenient it was to use.

The Quick Take

  • What they studied: How well a special ketogenic formula works to help control seizures in people whose epilepsy doesn’t respond to regular medications
  • Who participated: Children and adults with drug-resistant epilepsy from 41 different studies conducted over 25 years
  • Key finding: People using the ketogenic formula along with their ketogenic diet had better seizure control and were more likely to stick with their treatment
  • What it means for you: If you or a loved one has epilepsy that doesn’t respond well to medications, this formula might help make ketogenic diet therapy easier to follow and more effective

The Research Details

This was a scoping review, which means researchers looked at all the available studies about KetoCal from 1998 to 2024. They searched major medical databases and found 645 articles, then carefully selected 41 studies that met their standards. These studies included both children and adults with epilepsy that didn’t respond well to regular medications. The researchers looked at how well people stuck to their treatment, how many seizures they had, and whether there were any side effects.

This type of review is important because it brings together evidence from many different studies over a long time period. Instead of looking at just one small study, researchers can see patterns across thousands of patients and many years of use.

The researchers used strict criteria to select only studies that clearly reported results for the ketogenic formula separately from other treatments. However, they didn’t rate the quality of individual studies, which means some included studies might be stronger evidence than others.

What the Results Show

The main finding was that people who used the ketogenic formula along with their ketogenic diet appeared to have better seizure control than those who followed the diet alone. Several studies showed that adding the formula led to greater reductions in both how often seizures happened and how severe they were. People were also more likely to stick with their treatment when they used the formula, which is crucial because ketogenic diets can be very difficult to follow long-term. The compliance rates varied between studies, but generally appeared higher when the formula was included in the treatment plan.

An unexpected discovery was that this ketogenic formula is increasingly being used in hospital intensive care units to treat a very serious condition called status epilepticus, where seizures don’t stop on their own. Patients and their families generally rated the formula highly for taste and convenience, which helps explain why people were more likely to stick with their treatment. The formula was also found to be nutritionally complete, meaning it provides all the nutrients people need while maintaining the high-fat, low-carb ratios required for ketogenic therapy.

This review confirms what individual studies have suggested for years - that ketogenic diets can help control seizures when medications fail. What’s new is the clear evidence that adding a specialized formula makes this challenging diet much more practical and effective for real-world use.

The review didn’t specify exactly how many patients were included across all studies, making it hard to know the total scope of evidence. The studies varied in how they measured outcomes and how long they followed patients. Some studies were small, and the researchers didn’t assess the quality of individual studies, so some evidence may be stronger than others.

The Bottom Line

For people with drug-resistant epilepsy, adding a specialized ketogenic formula to ketogenic diet therapy appears to improve both seizure control and the ability to stick with treatment. This seems most beneficial for those who struggle with the practical challenges of maintaining a strict ketogenic diet.

This research is most relevant for people with epilepsy that doesn’t respond well to medications, their families, and their healthcare teams. It may be especially helpful for children and adults who have tried ketogenic diets before but found them too difficult to maintain.

The studies showed benefits at various time points, but ketogenic diet therapy typically requires several months to see full effects. Improvements in compliance and convenience may be noticed more quickly.

Want to Apply This Research?

  • Track daily seizure frequency, severity (on a 1-10 scale), and adherence to ketogenic diet plus formula intake
  • Log ketogenic formula consumption alongside regular meals to monitor compliance with prescribed ratios and timing
  • Weekly tracking of seizure patterns, monthly assessment of diet adherence, and quarterly evaluation of overall treatment satisfaction and quality of life

This information is for educational purposes only and should not replace professional medical advice. Anyone considering ketogenic diet therapy for epilepsy should work closely with their healthcare team, including neurologists and registered dietitians experienced in ketogenic treatments.