It's a Gas: Possible Depression Treatment Worked Fast

Depression symptoms eased after treatment with nitrous oxide, also known as laughing gas

(RxWiki News) They say laughter is the best medicine — and that may prove true when it comes to depression. Laughing gas has shown some promising results for easing depression.

In a small preliminary trial, researchers found that laughing gas (nitrous oxide) may improve symptoms in patients with severe depression. The gas has demonstrated rapid results and few side effects.

Peter Nagele, MD, professor of anesthesiology at Washington University School of Medicine in St. Louis, led the study of 20 patients who had treatment-resistant depression.

“This is an exciting first step and evidence that there might be a real positive effect [of laughing gas]," Dr. Nagele told dailyRx News. "Given the small sample size, we cannot make any robust predictions as to how the treatment will do in a larger patient population.”

Antidepressants and psychological counseling can relieve depression symptoms in most people. Up to 1 in 3 patients with major depression, however, have a treatment-resistant form of the condition, according to a past study published in American Family Physician.

Dr. Nagele and team found that two-thirds of the patients reported an improvement in symptoms after treatment with nitrous oxide. One-third of the same patients had improved symptoms after receiving a placebo (fake treatment).

Subjects reported on the severity of their symptoms two hours after treatment and again the next day. They noted levels of sadness, feelings of guilt, suicidal thoughts, anxiety and insomnia.

One day after nitrous oxide treatment, seven patients had mild improvement in symptoms. Another seven had significant improvement. For three patients, symptoms had disappeared almost completely. Symptoms did not worsen for any patient taking nitrous oxide.

When taking the placebo, one patient had worse symptoms the next day. Five had mild improvements on the placebo. Two said they felt much better.

The same patients went through two different sessions. In one session, they were given a gas mixture of half oxygen and half nitrous oxide. This is the same mix dentists use on patients undergoing dental procedures.

In a second session, patients took in a placebo mixture of oxygen and nitrogen. These are the two primary gases in the air we breathe.

Study author Charles R. Conway, MD, professor of psychiatry at Washington University, said many of the patients receiving nitrous oxide reported a rapid improvement.

“Most patients who improved reported that they felt better only two hours after treatment with nitrous oxide,” Dr. Conway said in a press release. “That compares with at least two weeks for typical oral antidepressants to exert their beneficial, antidepressant effects."

Dr. Nagele and team noted that standard antidepressants — such as Prozac, Zoloft, Lexapro and other selective serotonin reuptake inhibitors (SSRIs) — can take weeks before they provide symptom relief. Cognitive behavior therapy and similar treatments may also take weeks before having an effect.

Dr. Nagele told dailyRx News, however, that it is not likely that laughing gas will become a widely used alternative to antidepressant medications.

“We see [laughing gas] as potential for situations where rapid antidepressant effects are warranted and for patients with treatment-resistant depression,” he said.

Study author Charles F. Zorumski, MD, head of the Department of Psychiatry at Washington University, added that a fast-acting treatment like this might be useful in patients with severe depression who may be at risk for self-harm and need help right away.

Laughing gas treatment is not approved by the US Food and Drug Administration. It is considered an experimental treatment. Dr. Nagele and team said more research is needed to further explore the effects of nitrous oxide on depression.

This research was presented Dec. 9 at the annual meeting of the American College of Neuropsychopharmacology in Scottsdale, AZ. It was published online the same day in the journal Biological Psychiatry.

The departments of anesthesiology and psychiatry at Washington University and the Taylor Family Institute for Innovative Psychiatric Research funded the study. Dr. Nagele has filed for intellectual property protection related to the use of nitrous oxide in major depression. The authors disclosed no conflicts of interest.


Review Date: 
December 9, 2014