Recreational use of nitrous oxide (NO) has increased among young people, and while medical use at controlled doses is generally safe, abuse can cause toxicity. The most common consequence is subacute combined degeneration of the spinal cord, often presenting as myeloneuropathy (spinal cord demyelination and peripheral nerve injury). Other reported effects include cognitive, psychiatric, dermatological, gastrointestinal, cardiovascular, and pulmonary disorders. This chapter reviews major neurological impairments from NO abuse—myelopathy, peripheral neuropathy, and cognitive/psychiatric conditions—to raise awareness and help clinicians recognize, investigate, and manage NO-related neurotoxicity.
A meta-analysis of 10 randomized controlled trials involving 1,058 people with insomnia and anxiety-depressive symptoms found that adding 4–12 weeks of mindfulness therapy to conventional treatment significantly reduced depression and anxiety scores compared with conventional treatment alone. Mindfulness therapy lowered Hamilton Depression Scale scores by an average of 3.67 points and Hamilton Anxiety Scale scores by 3.23 points. It also reduced Self-Rating Depression Scale scores by 6.49 points and Self-Rating Anxiety Scale scores by 7.97 points. The authors conclude that mindfulness therapy can improve anxiety and depression symptoms in people with insomnia, though they note methodological limitations and call for further well-designed trials.