The neuropsychiatric effects of nitrous oxide and low vitamin B₁₂

Abstract

SUMMARY This 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.

Diverse avenues of research support the transmethylation theory of psychosis: implications for neuroprotection

“…Nitrous oxide (N 2 O) abuse by individuals, disabling the function of B12, has been commonly associated with psychosis [141]. Sethi et al [143] reported on a case of abuse of N 2 O, causing functional B12 deficiency and psychosis, wherein treatment with B12 was effective. Farmer et al [144] reviewed the effects of N 2 O abuse on CNS function, and summarize treatment recommendations.…”