Home /



Laughing Gas as a Treatment for Depression?

Laughing Gas as a Treatment for Depression?

Jan 14 , 2021
Clinical depression can cause severe disability and can be a fatal disease. Although many people with this disease respond well to standard treatments, there are still a large number of patients who have not improved. Their disease is considered "difficult to treat". Depression may have multiple causes/types; some types may respond to one type of treatment and not others.

The pain caused by this disease can be so severe that people may commit suicide. When patients with suicidal depression are treated for psychiatric illness, they may still be extremely dangerous to themselves even a few weeks after starting various treatment trials. Even if a person is hospitalized, this risk of suicide may continue to exist.

Ketamine is a drug used in certain emergency room procedures, especially in children. An example of this type of surgery is the reduction of a dislocated shoulder. Ketamine can reduce pain and cause a brief period in which the patient is conscious but indifferent to the operation. (This is called dissociative anesthesia.) The drug can provide this anesthesia without affecting breathing ability.

Ketamine can also reduce pain and produce conscious sedation and analgesia in adults. However, unlike children, adults often experience significant mental side effects, and may experience hallucinations, perceptual disturbances, and ketamine delusions. Therefore, ketamine, like its cousin phencyclidine (PCP, also known as angel powder), is considered to be a psychotropic drug, that is, a drug that can cause psychotic symptoms. It is believed that children do not experience the psychotic effects of ketamine because the connections in certain brain regions are still immature. Throughout adolescence, the main functional brain pathways continue to form.

Studies in the past decade have found that in a relatively low proportion of patients with major depression, a single intravenous infusion of 40 minutes of sub-anaesthetic dose of ketamine can lead to rapid improvement of mood and relief of suicidal ideation. This effect starts within a few hours after the administration of ketamine and lasts for several days. The most obvious disadvantage of ketamine is that it may cause mental illness and cognitive side effects. This effect usually does not last long, but it can be disturbing. Optimal dosage, frequency of administration and even route of administration are all active areas of research.

Ketamine is thought to work by blocking the action of a neurotransmitter called glutamate on a specific type of glutamate receptor called NMDA receptor. Blocking NMDA receptors can quickly change the function and connection of certain brain pathways. These changes in brain pathways may be related to the relief of depression symptoms.

The use of ketamine as a potential treatment for depression is complicated by its mental side effects and the fact that it is sometimes abused as a recreational drug. The latest research report published by Dr. Peter Nagele and his colleagues in the journal Biological Psychiatry stated that nitrous oxide ("laughing gas") is an inhaled anesthetic commonly used by dentists during dental surgery, which can help patients Patients with depression. (Open: One of us (CZ) is a co-author of the paper.)

Why would anyone even consider the possibility of nitrous oxide helping patients with major depression? Facts have proved that nitrous oxide, like ketamine, can prevent the effect of glutamate on NMDA receptors, but the mechanism is different from that of ketamine. (Disclosure: CZ was originally discovered as an inhibitor of nitrous oxide as an NMDA receptor.) Unlike ketamine, nitrous oxide does not have psychogenic properties, although it is sometimes abused like ketamine.

In a proof-of-concept study, Nagele and colleagues compared the antidepressant effects of a single dose of nitrous oxide with placebo gas (nitrogen) in 20 patients with treatment-resistant depression. Each patient undergoes a separate crossover test every other week and is tested with two treatments (nitrous oxide and placebo). Nitrous oxide is administered for approximately 50 minutes at a dose similar to that of a dentist's office.

The results of this study are intriguing. When compared to the placebo gas, nitrous oxide led to substantial improvement: 35 percent of patients demonstrated a very good to excellent response with nitrous oxide versus 5 percent with placebo. The benefits lasted for several days and at least a week in some patients. This response rate is remarkable considering that the patients selected for this study had previously failed an average of 8 (range 4-12) antidepressant treatments.

Psychotic side effects were not observed. A few patients experienced gastrointestinal (GI) side effects or anxiety at the dose of nitrous oxide used in the study. It is possible that a lower dose of nitrous oxide still might be effective and may have even fewer side effects. Because nitrous oxide is a commonly used agent, it is likely that studies following up these initial findings will occur soon.

Future studies will determine the lowest effective dose and length of treatment as well as the effectiveness of repeated administrations. Until these findings are replicated and until much more information is known about dosing and safety, this treatment should be administered only in a research setting.

It would be remarkable if a drug known as “laughing gas” turned out to be beneficial in alleviating severe depressive symptoms including thoughts of suicide. If so, this might become an emergency intervention for those with severe depressive symptoms accompanied by suicidal intent. Also, certain symptoms of depression such as suicidal thoughts can occur in other disorders such as personality disorders. Do suicidal thoughts improve with this treatment in people with personality disorders? There is no answer to this question at present.

This research involving nitrous oxide as a potential treatment for depressive symptoms is very preliminary. A lot more work is needed before a reasonable understanding of the potential benefit versus the risks can be determined. Hopefully, this small study will lead to further well designed clinical studies.

Leave A Message
Leave A Message
If you are interested in our products and want to know more details,please leave a message here,we will reply you as soon as we can.