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Laughing Gas: the Pros and Cons

A middle aged youth sits calmly at a hospital. Except for the mound of rope that binds his hands, there is nothing unusual about the patients awaiting a date with the doctor here.

Suddenly, the youth starts fidgeting with the knot on his hands and without warning he erupts into a scream that freezes a group of children playing nearby. He almost breaks free from the grip of the two men who struggle to pin him to the bench.

But a lending hand by a hospital security guard who has been closely watching the trio keeps the hostile patient held. A female nurse appears and jabs the patient with a two inch injection, then takes some measured steps back to await effect.

The strained expression of the patient appears to calm down and within seconds, he amuses the gathering crowd with a bout of laughter and soon falls asleep.

“I have given him a sedative as he awaits the doctor,” explains the nurse. “Soon he will join other mentally ill patients at the male wards where he will undergo further treatment.”

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A pilot study by scientists at the university could lead to the first ever treatment for severe depression with nitrous oxide, aka laughing gas. But this is for patients who defy known therapies, medics say.

Some of the treatment that the patient may be attended with could be through doses of nitrous oxide, or the one known as ‘laughing gas’, according to new research at the Washington University School of Medicine in St. Louis.

Published in the Journal of Biological Psychiatry early December 2014, the findings have been described as ‘encouraging’ by researchers, since most patients with clinical depression don’t respond to known treatment for days or even weeks.

But with nitrous oxide, two thirds of the 20 patients undergoing treatment at St. Louis showed progress after 24 hours, researchers said in an article published on December 9, 2014 by the Washington University.

“Treatment that yields quick results for mentally ill patients isn’t available in Africa,” observes George Mugo, a community psychiatrist. “The research could be a game changer but care should be taken because what works in the west doesn’t mean it is applicable in other parts of the world.”

According to Mugo, nitrous oxide is widely used in medicine and could be useful in marginalized communities where patients still seek the services of witchdoctors.

“It is not in the list of controlled drugs, but it can be deadly when abused in an uncontrolled environment,” he says.

The Africa Mental Health Research Foundation (AMHRF) however is convinced such a breakthrough could help bridge expertise between the North and South.

“That is a big gap,” reasons Rhodah Mwangi, the communication officer at AMHRF. “Mental health has been neglected in low income countries.”

The Foundation has conducted a couple of epidemiological studies to gauge the gravity of the problem in Africa, but its officials confirm that little has been done in terms of research.

Nitrous Oxide

Laughing Gas is on the WHO Model List of Essential Medicines, the most important medications needed in a health system.

“We haven’t done studies testing a particular style of treatment,” says Mwangi. “However, interventions such as treatment with nitrous oxide before the situation has gone to a level of serious mental illness are important.”

The findings of the research could usher in a cheaper and more efficient treatment for mental disorders. But its wider use for leisure continues to worry health experts.

Hopes & Worries of Laughing Gas

John Kibia approaches the disc jockey cabin and trades a few words. He fishes some money from his wallet and gives it to the attendant behind the counter. At the Tortillas club along Thika super highway, frenzied revelers dance away the night with relish.

Soon he is puffing a smoky substance curling away from a thin pipe and joins his colleagues’ table. Even before five minutes have clocked away, he slumps on his chair and starts murmuring to himself.

His colleague taps him on the shoulder and asks him if he is alright. Kibia slides into violence. It is time to go home.

“Nitrous oxide like any other drug can be harmful and even deadly when used outside a medical facility,” argues John Mutuho the chairman of Kenya’s National Authority for the Campaign against Alcohol (NACADA). “However it doesn’t fit in our list of drugs and that is why it is commonly used in clubs.”

Health experts say the gas can limit the flow of oxygen in the body, leading to headaches, dizziness and even fainting.

“It’s okay if the gas is used to advance medical research,” reasons Mututho. “But NACADA considers its use outside these limits as drug abuse.” Previous known treatment for mental disorders was through drugs such as Prozac, Zoloft and Lexapro.

This article was first published in 2008 and is currently republished for its relevance.