Nitrous oxide (laughing gas) inhalation as an alternative to electroconvulsive therapy.

Abstract

Electroconvulsive therapy (ECT) is used widely in the treatment of psychiatric conditions; however, its use is not without controversy with some recommending a moratorium on its clinical use. Complications and side effects of ECT include memory loss, injury, problems originating from sympathetic stimulation such as arrhythmias and myocardial ischemia and the risk of general anesthesia. Nitrous oxide (laughing gas) could potentially substitute for ECT as it shares some similar effects, has potential beneficial properties for these psychiatric patients and is relatively safe and easy to administer. Nitrous oxide induces laughter which has been described as nature's epileptoid catharsis which one might surmise would be beneficial for depression. It also produces a central sympathetic stimulation similar to ECT and causes release of endogenous opioid peptides, which are potential candidates for the development of antidepressant drugs. Nitrous oxide is also associated with seizure like activity itself. Administration of nitrous oxide as a substitute for ECT is eminently feasible and could be given in a series of treatments similar to ECT therapy.