Abstract

Depressed patients failing to respond to a series of antidepressant treatments are referred to as having treatment-resistant major depression (TRMD). Recently, inhaled agents, including nitrous oxide, isoflurane, and xenon, have emerged as a promising TRMD therapeutic class. Nitrous oxide, an N-methyl d-aspartate (NMDA) receptor antagonist, demonstrated antidepressant efficacy in a double-blind trial with limited side effects. Like ketamine, it appears to lower suicidal ideation. Isoflurane, also an NMDA-antagonist, is a halogenated methyl ethyl ether compound and isomer of enflurane. Isoflurane brings about electroencephalographic burst suppression associated with antidepressant efficacy, which rivals electroconvulsive therapy, without potential negative side effects. Xenon is a noble gas with anesthetic properties with preclinical animal studies demonstrating antidepressant-like qualities. Mechanisms through which nitrous oxide, isoflurane, and xenon produce antidepressant effects remain unclear, but all antagonize NMDA receptors. Finally, aromatherapy, inhalation of distilled plant oils, is used for depressive disorders but current systematic study is scant.

Original languageEnglish
Title of host publicationManaging Treatment-Resistant Depression
Subtitle of host publicationRoad to Novel Therapeutics
PublisherElsevier
Pages481-491
Number of pages11
ISBN (Electronic)9780128240670
ISBN (Print)9780128240687
DOIs
StatePublished - Jan 1 2022

Keywords

  • Aromatic compounds
  • Depressed patients
  • Isoflurane
  • Major depressive disorder
  • Nitrous oxide
  • Plant oils
  • Xenon

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