“Nitrous Oxide” shows a promise for difficult-to-treat depression-Consumer Health News

Thursday, June 10, 2021 (HealthDay News) –If antidepressants cannot control difficult-to-treat depression, a common anesthetic, best known as “laughing gas,” is safe and effective. New research suggests that it may be an alternative.

This finding follows a study of 28 patients suffering from “treatment-resistant major depression,” and researchers say about one-third of all patients who develop major depressive disorder. Affects an estimated 17 million American adults.

For such patients, antidepressants often do not provide relief. However, three 1-hour laughing gas inhalation sessions over a three-month period significantly reduced depression in 85% of patients, weeks after treatment.

“Nitrous oxide is nitrous oxide, one of the oldest and most commonly used anesthetics,” explains Peter Nagele, chair of the Anesthesia and Critical Care Division at the University of Chicago. ..

“And we found that much lower concentrations of laughing gas, for example, than those used during dental procedures, can help patients with depression who are difficult to treat,” Nagele said.

Between 2016 and 2019, Nagele’s team tried two laughing gas formulations. One has nitrous oxide levels of 50% and the other has levels of 25%.

Previous studies have already shown higher levels of antidepressant effects. However, those efforts only evaluated the effect after 24 hours of treatment. Patients exposed to high doses generally experienced side effects such as nausea, sedation, and / or “mild dissociation,” a type of daydream experience.

In the latest study, patients were between the ages of 18 and 75. Everyone was told to continue their usual depression treatment and maintain their existing antidepressant regimen.

Approximately one-third received three 50% nitrous oxide inhalation treatment sessions, one-third received 25% nitrous oxide inhalation therapy, and one-third received oxygen-free oxygen inhalation therapy. received.

Treatment was via a standard anesthesia face mask and was monitored by all for up to 1 hour after treatment.

Results were derived from 20 patients who completed all three inhalation sessions and 4 patients who completed at least one treatment after 4 patients withdrew from the study.

Researchers have found that both formulations significantly control depression. In fact, the team said they were able to “quickly” control their depression in just one session (either dose).

Depression control also appeared to be more effective over time, lasting up to 1 month after treatment in some patients. At 3 months, the team found that 85% of patients had improved symptoms and 40% had ameliorated depression.

Perhaps just as importantly, the team also found that “using low concentrations of nitrous oxide also reduces the risk of side effects by a factor of four.”

So how does laughing gas relieve depression?

“The mechanism by which nitrous oxide exerts antidepressant effects is unknown and may differ from the mechanism that causes sedation, unconsciousness, and pain relief,” says Nagele. “That said, the most widely accepted theory is that nitrous oxide blocks certain receptors in the brain called NMDA receptors. [the medication] Ketamine. “

Ketamine is a Class III prescription drug. Hospitals traditionally use the drug as an anesthetic, but its potential as an “off label” treatment for depression is also being investigated.

According to Stephen Holon, a professor of psychology at Vanderbilt University in Brentwood, Tennessee, “ketamine is the focus of much attention” in the world of alternative depression research.

Hollon admitted that he was not involved in the new study and was not familiar with the details of the study of nitrous oxide treatment of depression. Nevertheless, he emphasized that this finding “suggests a common mechanism” with ketamine. And he described Nagele’s work as “the most striking” proof-of-concept “study, and this issue was pursued. It makes me want to see it. “

Depression control seen among patients exposed to low-dose laughter gas was “equal to or better than the hope obtained in placebo-controlled trials with antidepressants, which are refractory to treatment. I’m a patient. [It’s] It’s very impressive, “Holon pointed out.

“If they provide this as pilot data, I would fund them for large-scale testing,” he added. “These are very promising findings.”

A report by Nagele and his colleagues appeared in the June 9th issue. Science translational medicine..

For more information

For more information on treatment-resistant depression, Mayo Clinic..

Source: Peter Nagele, Chair of the Department of Anesthesia and Critical Care, University of Chicago, Department of Anesthesia and Critical Care Medicine. Dr. Stephen Holon, Professor of Psychology, Vanderbilt University, Brentwood, Tennessee. Science translational medicine, June 9, 2021