The neuropsychiatric effects of nitrous oxide and low vitamin B12
Joseph Farmer, Karen Romain, Mina Ibrahim, Manoj Kumar, William York Moore
BJPsych Advances July 1, 2022 DOI: 10.1192/bja.2021.55 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Narrative review Peer reviewed |
|---|---|
| Key findings | The review argues that neuropsychiatric complications of nitrous oxide use are often mediated by low vitamin B12, and that because chronic nitrous oxide use can inactivate vitamin B12, standard blood test levels may not reflect functional B12 status, complicating correct interpretation of laboratory results. |
Abstract
SUMMARYThis narrative review article aims to update knowledge on the neuropsychiatric complications of nitrous oxide use and low vitamin B12. We consider common forms and uses of nitrous oxide (N2O) and review its mechanism of action, and then explore the potential impacts of use. In particular, neuropsychiatric effects mediated by low vitamin B12 are considered and the correct interpretation of laboratory results explored. This is of particular importance as where vitamin B12 is inactivated by chronic nitrous oxide use, blood test levels of vitamin B12 may not reflect the quantity of functional B12 in patients.
Citations in the library
Cited by 4
- Nitrous Oxide Abuse-Induced Vitamin B12 Deficiency and Neurological Injury IntechOpen eBooks May 28, 2026
- Diverse avenues of research support the transmethylation theory of psychosis: implications for neuroprotection Exploration of Neuroprotective Therapy May 21, 2024
- Relationships among nitrous oxide exposure, neurological injury and biomarkers. British Journal of Clinical Pharmacology July 20, 2026
- The Toxic Legacy of Recreational Nitrous Oxide Use: A Systematic Review and Meta-Analysis of Multisystem Complications From Functional Vitamin B12 Deficiency Cureus May 1, 2026