Impact of Nitrous Oxide on Neuropsychiatric Impairment in Adolescents: A Scoping Review.
Cureus August 1, 2025 Vanessa C Cornelio, Gary Lail, Kimberly Go et al.
Prolonged and frequent misuse of nitrous oxide, especially among adolescents and young adults, can cause lasting neuropsychiatric harm. The gas disrupts vitamin B12 metabolism, impairing myelin production and leading to spinal cord degeneration. Neuroimaging shows deactivation of the hippocampus and visual cortices, matching observed memory and sensory deficits. Psychiatric complications include depression, delusions, and agitation. Early intervention with cessation, vitamin B12 supplementation, and medications such as naltrexone and aripiprazole may help. Epidemiological factors like low socioeconomic status, peer influence, and concurrent alcohol or cannabis use increase the likelihood of misuse. Significant gaps remain in understanding long-term outcomes and effective treatments.