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Laughing gas not only makes people laugh, it can also cause feelings of euphoria. Now, a new study suggests that laughing gas, or nitrous oxide, may relieve depression in patients who are resistant to other treatments.
Two weeks after inhaling a mixture of laughing gas and oxygen for an hour, participants in an early stage clinical trial had less severe symptoms of depression than two weeks after placebo treatment, according to research published on June 9 in the newspaper. Science Translational Medicine.
“A large percentage of patients do not respond to standard antidepressant treatments,” said Dr. Charles R. Conway, professor of psychiatry at Washington University in St. Louis and one of the study’s principal investigators, said in a press release. “The fact that we saw rapid improvements in many patients in the study suggests that nitrous oxide may help people with really severe, resistant depression.”
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Up to one third of patients with depression, or up to 17 million people in the United States, do not respond to standard treatments, most of which stimulate the serotonin and norepinephrine receptors in the brain, indicates the press release.
Patients in this study had tried an average of 4.5 different antidepressants and had suffered from depression for an average of 17.5 years, according to the study.
“Even with the best medication algorithms available to us, a number of people still have significant symptoms that affect their quality of life, sometimes very severely. So there is a range of treatments available. [for treatment-resistant major depression], but none of them are easy, ”said Dr. Timothy Sullivan, director of psychiatry and behavioral science at Staten Island University Hospital in New York, who was not involved in the new study. These alternatives include deep brain stimulation, which involves implanting an electrode into the brain, and vagal nerve stimulation, which involves implanting a pacemaker-like device that stimulates the brain. vagus nerve, Sullivan told Live Science. “We certainly need more and more accessible treatments for the treatment of this disease. Any treatment that promises to solve this problem is certainly worth considering.”
Another such alternative, Sullivan said, is esketamine, a form of anesthetic ketamine, which the Food and Drug Administration approved for treatment-resistant major depression in 2019 and has successfully treated some patients with depression who do not respond to other treatments, such as Previously reported live science. Both ketamine and esketamine job, at least in part, by binding to receptors for glutamate N-methyl-D-aspartate (NMDA), a type of receptor on neurons, or brain cells.
Like ketamine and esketamine, nitrous oxide also binds to NMDA glutamate receptors. This similarity led Conway and Dr. Peter Nagele, professor and chair of the Department of Anesthesia and Critical Care at the University of Chicago, to hypothesize that laughing gas could help patients with treatment-resistant major depression. , they wrote in a 2015 study published in the journal Biological Psychiatry.
In this study, Conway, Nagele and colleagues reported that an hour’s administration of nitrous oxide had “rapid and marked antidepressant effects” in patients with treatment-resistant major depression. In this study, the antidepressant effects of inhaling nitrous oxide at a concentration of 50% were statistically significant two and 24 hours after treatment, the authors wrote at the time. The researchers were curious whether a lower dose of laughing gas, which could lead to a lower risk of nausea and other side effects, would also be effective, the authors wrote in their new study. They also wanted to test whether the effects would last longer than the 24 hours they had followed the patients in their previous study.
To this end, over three sessions approximately one month apart, 24 study participants with treatment-resistant depression inhaled 25% nitrous oxide, 50% nitrous oxide, or a placebo containing l. oxygen only for one hour. The team then periodically measured patients’ depressive symptoms using the Hamilton Depression Rating Scale, a 21-point assessment conducted by a healthcare professional, for two weeks after treatment. The 20 patients who completed the experiment received all three treatments to serve as their own control in the experiment, and all underwent follow-up examinations.
Two weeks after laughing gas treatment, patients had fewer depressive symptoms according to the rating scale. This was true at both concentrations of laughing gas, the authors wrote in their article. However, at a concentration of 50%, some patients have experienced nausea as a side effect of the treatment.
“When they were given 25% nitrous oxide, no one developed nausea,” Conway said in the statement. “And that lower dose was about as effective as the higher dose in relieving depression.”
After all three treatments, 55% (11 out of 20) of participants who completed the study experienced statistically significant improvement in at least half of their depressive symptoms, and 40% (eight out of 20) experienced remission at short term, according to the statement.
Of the patients who completed the study, 85% (17 out of 20) improved so much that their depression moved from one category to another, such as from severe to moderate depression, according to the press release.
As a next step, the researchers would like to study nitrous oxide, esketamine and a placebo in a larger multicenter trial, the statement said.
Sullivan said he would like to see the trial repeated by other investigators with more patients. “If these early results are certainly validated, it could well be offered as a treatment,” he said.
Originally posted on Live Science.
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