Laughter gas has been used to numb pain in dentists and maternity wards for more than a century, and researchers now believe that the gas, called laughter gas, can effectively treat depression when other treatments have failed.
That’s according to the results of a Phase 2 clinical trial published Wednesday in the journal Science Translational Medicine.
Up to 30 percent of people diagnosed with major depressive disorder do not respond to typical treatments, leaving a significant proportion of patients in need of new treatment options.
The landscape for these patients began to change in 201
“The discovery of ketamine is considered one of the biggest breakthroughs in depression research in 50 years,” said a co-author of the new study, Dr. Peter Nagele, Professor of Psychiatry and Behavioral Neuroscience and President of Anesthesia and Critical Care at the University of Chicago.
Nitric oxide is thought to work in the same way as ketamine, Nagele said.
The new study expanded on a previous proof-of-concept trial that showed that inhaling 50 percent nitric oxide – the amount typically used for pain management during medical procedures – reduced depressive symptoms in people who were resistant to others. treatments. Nagele and the other co-authors wanted to know if these effects lasted, as well as if a lower dose could give the same results with fewer side effects.
The trial included 24 participants. More than 70 percent were women, 96 percent were white, and all experienced treatment-resistant depression. Twenty participants completed the full trial, which involved receiving two doses – at 25 percent and 50 percent concentrations – of nitrous oxide and a placebo in a random order over three months. Each session took one hour.
According to one of the three measurements of depression used to measure progress, the lower dose of nitric oxide appeared to have a similar effect as the higher dose, but with fewer side effects, which commonly included headaches, nausea, and tingling. The effects also appeared to last up to two weeks in some patients.
However, the study is far from final.
“The key limitation is that it is a very small study,” said Ravi Das, a research psychopharmacologist at University College London.
Each participant received all three treatments, as opposed to in a randomized controlled clinical trial, where one group received the treatment and the other received placebo. While the design allowed researchers to compare people with themselves rather than to other people, it may also have mudded the results because a lasting effect of one treatment may have boosted the outcome of another, Das said.
Das said that despite its shortcomings, the new trial adds a promising research team.
“What I would like to see is the comparison of this with ketamine. If they produced similar effects, I would use nitrous oxide every time,” he said, noting that both drugs are cheap and easy to administer, but that nitrous oxide typically has milder side effects.
Dr. Madhukar Trivedi, director of the Center for Depression Research and Clinical Care at UT Southwestern Medical Center in Dallas, said: “One thing has become clear, especially after the success of ketamine: it is necessary to find different mechanisms to alter brain function. depression.
“What has been developed by drug manufacturers over the last 25 years is not enough,” said Trivedi, who was not involved in the lawsuit.
Nagele said the next step is to conduct a larger trial that includes hundreds of patients. “We need to be sure that it works and also understand why it might not work in some patients,” Nagele said.
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