Neurobiology and Applications of Inositol in Psychiatry: A Narrative Review

Abstract

Inositol is a natural sugar-like compound, commonly present in many plants and foods. It is involved in several biochemical pathways, most of them controlling vital cellular mechanisms, such as cell development, signaling and nuclear processes, metabolic and endocrine modulation, cell growth, signal transduction, etc. In this narrative review, we focused on the role of inositol in human brain physiology and pathology, with the aim of providing an update on both potential applications and current limits in its use in psychiatric disorders. Overall, imaging and biomolecular studies have shown the role of inositol levels in the pathogenesis of mood disorders. However, when administered as monotherapy or in addition to conventional drugs, inositol did not seem to influence clinical outcomes in both mood and psychotic disorders. Conversely, more encouraging results have emerged for the treatment of panic disorders. We concluded that, despite its multifaceted neurobiological activities and some positive findings, to date, data on the efficacy of inositol in the treatment of psychiatric disorders are still controversial, partly due to the heterogeneity of supporting studies. Therefore, systematic use of inositol in routine clinical practice cannot be recommended yet, although further basic and translational research should be encouraged.

Neurometabolic alterations in children and adolescents with functional neurological disorder

“…Accordingly, both lactate and MI may be involved in altered acid-base regulation that underpins—at least in part—altered function of acid-sensitive fear circuits ( Maddock et al, 2013 ). While formal resting-state spectroscopy assessments of brain mI levels in panic disorder have yet to be conducted ( Ham et al, 2007 ), 3 two small, randomized control trials point to the therapeutic benefit of mI supplementation for the management of treatment-resistant panic disorder ( Zulfarina et al, 2019 , Benjamin et al, 1995 , Palatnik et al, 2001 , Concerto et al, 2023 ). This emergent literature raises the intriguing possibility that mI supplementation could potentially be useful in the treatment of FND, and in particular the subgroup of patients with functional seizures with concurrent hyperventilation or comorbid panic disorder.…”

Possible prospects for the combined administration of antidepressants and antioxidants in neurological patients

“…В литературе описан ряд антиоксидантных соединений в качестве дополнительной терапии депрессии [8,19,20,28]. В доступных источниках есть клинические данные по аугментации АД фолиевой кислотой, метилфолатом, инозитолом, витаминами С и D, комбинацией фолиевой кислоты и витаминов B6 и B12; триптофаном (5-НТ); S-аденозилметионином; комбинациями эйкозапентаеновой кислоты и докозагексаеновой кислоты [19,33]. Недавнее исследование показало, что модифицированные селеном производные флуоксетина одновременно воздействуют на обратный захват 5-НТ (антидепрессивное действие) и на окислительный стресс, что приводит к многообещающим результатам [34].…”

“…Инозитол (В8) подавляет продукцию воспалительных цитокинов с помощью посттранскрипционного механизма, защищает от шока, вызванного эндотоксинами, ингибирует выработку в иммуностимулированных макрофагах и клетках селезенки провоспалительных цитокинов, фактора некроза опухоли, интерлейкинов 1, 12, провоспалительного белка-1-альфа, имеет инсулиноподобное действие [33]. Активность инозита обусловлена снижением образования активных форм кислорода, прямым удалением супероксидов, защитой передачи сигналов оксида азота.…”

Efficacy and safety of ketamine and esketamine for unipolar and bipolar depression: an overview of systematic reviews with meta-analysis

“…Other antidepressant drugs also promote noradrenergic (norepinephrine and serotonine reuptake inhibitors, SNRIs) and dopaminergic (norepinephrine and dopamine reuptake inhibitors, NDRIs, i.e., bupropion) neurotransmission ( 5 ). On the other hand, the management of BD involves a combination of pharmacotherapy, psychotherapy, and lifestyle modifications ( 10 ), as well as several non-pharmacological approaches ( 11 ). While there are also other molecules with antidepressant action, which altogether would theoretically allow even more specific intervention toward individual depressive symptoms ( 12 ), still many patients achieve partial response or become resistant to treatment ( 13 , 14 ).…”