When antidepressants fail to control difficult-to-treat depression, a popular anesthetic known as laughing gas may be a safe and effective option, according to a new study.
Nitrous Oxide Gas Can Treat Depression
The discovery was made after working with 28 patients suffering from treatment-resistant major depression, a serious illness that, according to researchers, affects around one-third of all patients, or an estimated 17 million American adults, who acquire major depressive disorder.
Antidepressants frequently fail to give help to such people. However, after three one-hour laughing gas inhalation sessions spread out over three months, 85 percent of patients experienced considerable depression reduction that lasted for weeks after therapy.
Laughing gas is nitrous oxide, one of the oldest and most widely used anesthetics, according to research author and University of Chicago chair of anesthesia and critical care Peter Nagele.
They also discovered that laughing gas, at considerably lower concentrations than are used, for example, during dental treatments, can benefit people with difficult-to-treat depression, according to Nagele.
Nagele’s team tested two laughing gas compositions between 2016 and 2019: one with 50 percent nitrous oxide and one with 25 percent.
Previous research has previously shown an antidepressant advantage at a greater dose. However, those attempts only looked at a 24-hour post-treatment benefit. Patients who received the greater dose frequently suffered adverse effects such as nausea, drowsiness, and/or moderate dissociation, a type of daydreaming experience.
Patients in the most recent research ranged in age from 18 to 75. All were instructed to continue with their standard depression treatment and medication prescription.
One-third were given three sessions of 50% nitrous oxide inhalation, one-third were given a 25% nitrous oxide inhalation, and one-third were given an oxygen inhalation therapy that did not include any laughing gas.
Treatment was administered using a conventional anesthetic face mask, and all patients were observed for up to one hour after treatment.
Following the withdrawal of four patients from the trial, the findings were derived from 20 patients who finished all three inhalation sessions and four patients who finished at least one treatment.
The researchers discovered that both formulations provided considerable depression management. The team found that a single session at either dosage achieved quick depression management in patients.
Depression management also appeared to improve over time, lasting up to a month after therapy in some individuals. At three months, the researchers discovered that 85 percent of patients experienced symptom improvement and 40 percent were in depressive remission.
Perhaps more crucially, the scientists discovered that utilizing a lower dose of nitrous oxide lowered the chance of negative effects by a factor of four.
So, how does laughing gas work to alleviate depression?
The mechanism by which nitrous oxide produces antidepressant effects is unknown, but it is likely distinct from how it promotes sleepiness and unconsciousness, as well as pain alleviation, according to Nagele. Having said that, the most frequently accepted explanation is that nitrous oxide inhibits the NMDA-receptor in the brain, which is also thought to be the key mechanism for the medicine ketamine.
Ketamine is a class III controlled substance. While the medicine is often used as an anesthetic in hospitals, it has also been studied for its potential as an off-label therapy for depression.
Ketamine is the trendiest thing happening in the field of alternative depression therapy research, according to Steven Hollon, a professor of psychology at Vanderbilt University in Brentwood, Tenn.
Hollon was not engaged in the current study and said that he is unfamiliar with the details of nitrous oxide depression therapy studies. Nonetheless, he emphasized that the discovery shows a shared mechanism with ketamine. And he described Nagele’s work as a remarkable ‘proof-of-concept’ research that made him wish to see the topic investigated further.
The depression control found in individuals exposed to low-dose laughing gas was comparable to or better than that shown in a placebo-controlled trial using antidepressant drugs, and these are treatment-resistant individuals. It’s extremely spectacular, according to Hollon.
He stated that if they presented this as pilot findings, he would support a larger experiment. These are encouraging results.