What is better for psychiatry: Titrated or fixed concentrations of nitrous oxide?
Frontiers in psychiatry January 1, 2022 Mark A Gillman
Medication dosages must be individualized; no single dose works for everyone. This paper contrasts fixed 25-50% concentrations of nitrous oxide (N2O) with the variable, titrated concentrations of Psychotropic Analgesic N2O (PAN) used in dentistry and neuropsychiatry. PAN is always titrated via an open nasal mask to the minimum concentration ensuring full consciousness, cooperation, comfort, and relaxation, guided by each subject's responses. Fixed concentrations, given via closed facial masks, ignore individual dose-response and may cause unconsciousness or adverse effects in sensitive subjects, requiring an anesthesiologist. PAN has been safely used in dentistry for over 70 years and in neuropsychiatry for over 40 years, with applications including substance abuse detoxification, depression amelioration, and investigations of schizophrenia, human orgasm, pain perception, and basic neuroscience. Experience with fixed doses in psychiatry is limited.