Neuropsychiatric disorders associated with recreational nitrous oxide use.
Clinical toxicology (Philadelphia, Pa.) November 1, 2023 Huijuan Wu, Liaoyang Xu, Xingyongpei Zheng et al.
Chronic recreational nitrous oxide use can cause functional vitamin B12 deficiency and neuropsychiatric complications. In a review of 16 patients aged 17–25, all had neurological symptoms like limb numbness, unsteady gait, and weakness; 12 also had psychiatric symptoms including hallucinations, agitation, depression, and personality changes. Twelve patients had vitamin B12 deficiency, and all 16 had elevated homocysteine levels. Fourteen showed abnormal spinal cord signals on MRI. Symptoms improved with vitamin B12 treatment and stopping nitrous oxide use. Clinicians should recognize nitrous oxide as a cause of neuropsychiatric problems in young adults.