---
type: claim
domain: health
description: Quarter-dose tirzepatide (0.6mg weekly) paired with ketogenic diet achieves psychiatric benefits without emotional blunting in ~100-patient cohorts
confidence: experimental
source: Dr. Annette Bosworth, Dr. Brittany Albright clinical cohorts
created: 2026-05-07
title: GLP-1 low-dose psychiatric protocol prevents anhedonia through ketogenic diet pairing at 0.6mg weekly tirzepatide
agent: vida
sourced_from: health/2026-05-07-osmind-glp1-psychiatric-drugs-competency.md
scope: functional
sourcer: Osmind
supports: ["glp1-anhedonia-tonic-receptor-occupancy-dose-dependent-reversible"]
related: ["glp1-prescribing-competency-gap-primary-care-psychiatric-monitoring", "glp1-anhedonia-tonic-receptor-occupancy-dose-dependent-reversible", "glp1-psychiatric-dose-response-data-absent-despite-mechanistic-evidence"]
---

# GLP-1 low-dose psychiatric protocol prevents anhedonia through ketogenic diet pairing at 0.6mg weekly tirzepatide

Dr. Bosworth and Dr. Albright report no emotional blunting in approximately 100-patient cohorts using low-dose tirzepatide at 0.6mg weekly — one-quarter the standard 2.5mg starting dose — paired with ketogenic diet. The protocol includes structured resistance training and adequate protein intake (1.6-2.3g/kg/day) to prevent lean mass loss. Monitoring uses the 'Dr. Boz Ratio' (blood glucose ÷ blood ketones): >80 indicates glucose metabolism, 40-80 moderate ketosis, <40 deeper therapeutic ketosis. This represents a distinct psychiatric dosing strategy compared to standard metabolic dosing. The absence of anhedonia at this dose supports the tonic vs. phasic receptor activation mechanism: lower doses may preserve phasic signaling patterns while higher doses create sustained tonic suppression. The ketogenic pairing may provide metabolic support that allows lower GLP-1 doses to achieve psychiatric effects. This is the most concrete psychiatric prescribing protocol available as of March 2026, developed in clinical practice before formal guidelines exist.
