If the diet is well tolerated and effective, the doctor will usually recommend continuing it for 1 to 3 years. Afterwards, carbohydrates are gradually increased, typically over 2-6 months. Suddenly stopping the diet may cause a temporary increase in seizures.
After the diet is discontinued, some children remain seizure-free with or without medications. However, seizures may recur, in which case they may be well controlled with medications that were ineffective before the diet. A patient who was seizure-free on a lower ratio of fats to protein and carbohydrates (for example, 2.75 to 1), but whose seizures recurred when the diet was discontinued, may be helped by continuing the diet at a reduced ratio or trying the modified Atkins or low glycemic diets.