Nitrous oxide causes peripheral neuropathy in a dose dependent manner among recreational users
Journal of Psychopharmacology February 1, 2020 A. Winstock, J. Ferris
Nitrous oxide use, both clinical and recreational, can cause peripheral neuropathy by inactivating a vitamin B12-dependent enzyme. Among over 16,000 past-year users surveyed across three years, 3.3% reported persistent numbness or tingling in hands or feet. The risk was very low for infrequent users but showed a strong dose-response relationship: the probability of paraesthesia rose from about 0.018 for 1–2 doses per session to about 0.085 for 100 doses per session. Age and gender also influenced the association. Heavy users face a dose-dependent risk of serious neurological harm, while occasional users are not at risk.