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Efficacy and safety of nitrous oxide for patients with treatment-resistant depression, a randomized controlled trial.

Danfeng Yan, Bangshan Liu, Xiyu Wei, Wenwen Ou, Mei Liao, Shanling Ji, Yan Peng, Jin Liu, Shibin Wu, Mi Wang, Yumeng Ju, Li Zhang, Zexuan Li, Lingjiang Li, Yan Zhang

Psychiatry research November 1, 2022 DOI: 10.1016/j.psychres.2022.114867 via PubMed

Summary

AI-generated from the abstract

A single one-hour inhalation of 50% nitrous oxide (N2O) mixed with oxygen rapidly alleviated depression in patients with treatment-resistant depression in China, but the effect lasted no more than one week. In a double-blind, placebo-controlled trial, 44 patients were randomized to receive either 50% N2O or a placebo mixture. Depression scores on the Hamilton Depression Rating Scale were significantly lower in the N2O group at two hours and 24 hours after treatment, but no significant difference remained at one week or two weeks. Patients receiving N2O reported more adverse events, all of which resolved within 24 hours, and no serious adverse events occurred.

Study at a glance

Characteristics Randomized controlled trial Placebo-controlled Double-blind Peer reviewed
Sample size 44
Population Patients with treatment-resistant depression in China
Dose 50% N2O/50% oxygen
Duration One-hour inhalation, two-week follow-up
Topics Depression
Keywords Nitrous oxide Randomized controlled trial
Key finding A single inhalation of 50% N2O produced a rapid antidepressant effect lasting less than one week in patients with treatment-resistant depression.

Abstract

Nitrous oxide (N2O), an N-methyl-D-aspartate glutamate receptor antagonist, has demonstrated a rapid-onset antidepressant effect for treatment-resistant depression (TRD) preliminarily in the United States. This study aimed to test the efficacy and safety of N2O for TRD patients in China. In this double-blinded, placebo-controlled trial, 44 patients with TRD were randomized to receive a one-hour inhalation of a mixture of either 50% N2O/50% oxygen (N2O group) or 50% air/50% oxygen (placebo group). The primary outcome was the change on the 17-item Hamilton Depression Rating Scale (HDRS-17) over a course of two weeks. Using modified intention-to-treat analysis, the between group difference was found in the HDRS-17 score at two hours and 24 h after inhalation treatment, while no significant difference was found in week one and week two. Patients receiving N2O reported a significantly higher number of adverse events. All the adverse events lasted for no more than 24 h. No serious adverse events were reported. A single inhalation of 50% N2O effectively alleviates depression in patients with TRD in China. The efficacy lasts for no more than one week. N2O is safe for patients with TRD.

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