Nitrous oxide use and psychiatric disorders: a retrospective clinical cohort study on prevalence and patterns.
Rebecca Paetow, Maike Franziska Dohrn, Michelle Finner-Prével, Leona Boesehans, Dariush Henning, Marcus Rust, Thomas Frodl
Frontiers in Psychiatry 2025 DOI: 10.3389/fpsyt.2025.1670500 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Retrospective observational cohort study Peer reviewed |
|---|---|
| Sample size | 287 |
| Population | Patients at the Department of Psychiatry, Psychotherapy and Psychosomatics of RWTH Aachen University Hospital |
| Duration | Six-month period in 2024 |
| Topics | Depression |
| Keywords | ADHD Cannabis-related disorders Lifetime prevalence Nitrous oxide Novel psychoactive substance Psychiatric disorders Substance use |
| Key findings | 7.67% of psychiatric patients reported lifetime nitrous oxide use, with younger age and diagnoses of major depressive disorder, cannabis-related disorder, and ADHD being common among users. |
Abstract
Nitrous oxide (N2O) is used for anesthetic purposes but has gained popularity as a recreational substance. Despite its potentially severe adverse effects, knowledge about N2O use within psychiatric populations is limited. This study aimed to evaluate the life-time prevalence and patterns of N2O consumption among patients with psychiatric disorders. A retrospective observational cohort study was conducted at the Department of Psychiatry, Psychotherapy and Psychosomatics of the Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen University Hospital, involving assessments of N2O use lifetime prevalence among patients in various psychiatric settings over a six-month period in 2024. Further data on demographic characteristics and psychiatric diagnoses were collected from electronic patient records. Out of 287 screened records, 22 patients (7.67%) reported a N2O use history, with a positive statistical relationship between younger age and positive lifetime prevalence (mean age: 28.14 ± 7.29 years, range 19-48 years, 6/22 female). Most users acquired N2O through low-threshold means such as friends or social events. The predominant psychiatric diagnoses among users included major depressive disorder, cannabis-related disorder and attention deficit and hyperactivity disorder. This study highlights the concerning life-time prevalence of N2O use in a clinical psychiatric sample, emphasizing the need for increased awareness and education regarding its potential risks and side effects. Given the vulnerability of this population to substance-related issues, routine assessment for N2O use should be integrated into standard psychiatric evaluations.
Comparable studies
Other observational and cohort studies on depression, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Metacognitive awareness and prevention of relapse in depression: Empirical evidence. Residually depressed patients and nondepressed controls; recovered depressed patients | 2002 | Observational cohort with intervention components | |
| Psilocybin for treatment-resistant depression: fMRI-measured brain mechanisms. Patients with treatment-resistant depression | 2017 | Observational cohort | n = 19 |
| Antidepressant effects of a single dose of ayahuasca in patients with recurrent depression: a preliminary report Patients with a depressive disorder | 2015 | Observational study | |
| Concomitant BDNF and sleep slow wave changes indicate ketamine-induced plasticity in major depressive disorder Patients with treatment-resistant major depressive disorder | 2012 | Observational cohort | n = 30 |
| Altered peripheral immune profiles in treatment-resistant depression: response to ketamine and prediction of treatment outcome Healthy controls and actively depressed patients with treatment-resistant depression... | 2017 | Observational cohort | n = 59 |
Citations in the library
Cites 11
- [Nitrous oxide as a party drug]. Die Anaesthesiologie July 1, 2024
- Neurological disorders caused by recreational use of nitrous oxide—a retrospective study from a German metropolitan area and review of the literature Neurological Research and Practice May 4, 2025
- Tackling the growing burden of nitrous oxide-induced public health harms. The Lancet Public Health February 1, 2025
- Increase of nitrous oxide-induced neurological disorders – a German multicenter experience Neurological Research and Practice January 16, 2025
- Review article: Clinical manifestations and outcomes of chronic nitrous oxide misuse: A systematic review Emergency Medicine Australasia June 13, 2022
and 6 more in the library