Nitrous Oxide (N2O) as a Treatment for Refractory Depression: A Word of Caution.
Journal of Clinical Psychopharmacology September 12, 2020 K. Fluegge
A letter to the editor raises concerns about using nitrous oxide (N2O) for treatment-resistant major depressive disorder (trMDD). The authors note that cobalamin dysregulation and folate deficiency are already documented in trMDD, citing evidence that cerebrospinal fluid metabolite abnormalities appear in over half of such patients, with cerebral folate deficiency most common, and that vitamin B12 levels predict deep white matter hyperintensities in MDD. They argue that N2O could worsen these effects, especially since its antidepressant effects are transitory, and call for clarifying why one-carbon metabolism dysregulation exists before considering N2O as a treatment.