Nitrous oxide, is a gas with mild sedative and pain-relieving effects, which you might have encountered at your dentistry chair or during childbirth. It is the most famous for its unique side-effect of making people euphoric, which earned it a label of the laughing gas. Knowing that laughter is a potent mood booster, it is surprisingly that up to now, nitrous oxide has not yet been tested as a potential treatment for the low mood disorder- depression. The pilot study, published recently in the Biological Psychiatry, was the first attempt to tackle depression with laughing gas. The study is small but results are extremely encouraging; among 20 patients with treatment-resistant depression, two-thirds noted a positive effect on their symptoms after receiving nitrous oxide. In contrast, only one third of patients treated with placebo (air) experienced improvements. The trial had a cross-over design and each study participant had a 1-hour inhalation session of nitrous oxide as well as a placebo, spaced a week apart. The effects of treatment were evaluated 2h and 24 h after treatments, based on the patients’ self-reported symptoms of depressions such as sadness, guilt, anxiety, insomnia and suicidal thoughts. It is unlikely that the improvement of symptoms was only due to acute euphoric effects of the gas, as beneficial effects lasted for up to 24 h or even longer in some patients. However, the question remains whether symptoms of depression indeed improved literally overnight or they were rather masked by some transient effects the gas could have on our mood, similarly to the well-recognized “masking” effects of cocaine and other psychostimulants. Nevertheless, regardless of the mechanisms behind improved symptoms, nitrous oxide brings an extremely quick relief as compared to conventional antidepressants, which may need 2 weeks to build their full potency. This raises the possibility that laughing gas could be used for the most critical patients, as a “bridge” therapy, while they wait for the prescribed medications to take an effect. However, as a repeated exposure to the gas leads to addiction and to potentially lethal vitamin B12 deficiency, we first have to learn if benefits indeed exceed potential risks.
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