Laughing Gas Used to Treat Depression
There are at least two problems with antidepressant medication. The first is they can take between six to eight weeks before any therapeutic effect is felt and the second is around a third of people who take antidepressants feel no therapeutic effect whatsoever. For someone who is deeply depressed and possibly suicidal waiting up to six weeks for a tablet to kick in, even assuming it does, is a tall order. What is needed is something much faster. Perhaps something that can bridge the gap between immediate need and future antidepressants. Step forward Nitrous Oxide (laughing gas).
According to Peter Nagele, M.D., and colleagues, nitrous oxide provides a ‘rapid and marked antidepressant effect in patients with treatment-resistant depression.’ Hold on, not only does it have an immediate therapeutic effect, it also goes where other treatments have failed before? According to the preliminary studies published in Biological Psychiatry that’s exactly what the team is suggesting.
In previous studies the rapid antidepressant effect of ketamine has been noted. The team hypothesized that nitrous oxide would respond in a similar fashion because it too is an NMDA receptor antagonist (a class of anesthetic). Other NMDA receptor antagonists include amantadine, memantine and methadone. Nitrous oxide is probably best known as the gas used by dentists and it was the exact concentration used by dentists that Nagele and his team used with a placebo-controlled study with 20 treatment-resistant major depressive patients.
After receiving nitrous oxide two-thirds of the volunteers experienced improved symptoms. The effects of the treatment were further replicated over the subsequent 24-hour period. Two hours after treatment and again the next day, volunteers were questioned as to their symptoms. None of the patients felt any worse but after just one treatment, seven reported mild improvement while a further seven reported significant improvement. Three patients stated that their symptoms had all but disappeared.
These initial findings appear to show promise although the exact mechanism as to why depression appears to be lifting still isn’t known. The next step is to trial varied concentrations of the gas to see how each influences depression. Nagele also observed that, ‘it’s kind of surprising that on one ever thought about using a drug that makes people laugh as a treatment for patients whose main symptom is that they’re so very sad.”