Department of Psychiatry, Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands.
Int J Mol Sci. 2022 Nov 25;23(23):14747. doi: 10.3390/ijms232314747.
The recreational use of nitrous oxide (NO) has increased over the years. At the same time, more NO intoxications are presented to hospitals. The incidental use of NO is relatively harmless, but heavy, frequent and chronic use comes with considerable health risks. Most importantly, NO can inactivate the co-factor cobalamin, which, in turn, leads to paresthesia's, partial paralysis and generalized demyelinating polyneuropathy. In some patients, these disorders are irreversible. Several metabolic cascades have been identified by which NO can cause harmful effects. Because these effects mostly occur after prolonged use, it raises the question of whether NO has addictive properties, explaining its prolonged and frequent use at high dose. Several lines of evidence for NO's dependence liability can be found in the literature, but the underlying mechanism of action remains controversial. NO interacts with the opioid system, but NO also acts as an N-methyl-D-aspartate (NMDA) receptor antagonist, by which it can cause dopamine disinhibition. In this narrative review, we provide a detailed description of animal and human evidence for NO-induced abuse/dependence and for NO-induced neurotoxicity.
一氧化二氮（Nitrous Oxide，NO）的消遣性使用近年来有所增加。与此同时，越来越多的一氧化二氮中毒案例被送往医院。偶然使用一氧化二氮相对无害，但大量、频繁和慢性使用会带来相当大的健康风险。最重要的是，一氧化二氮会使辅因子钴胺素失活，进而导致感觉异常、部分瘫痪和广泛脱髓鞘多发性神经病。在一些患者中，这些疾病是不可逆的。已经确定了几种代谢级联反应，其中一氧化二氮会产生有害影响。由于这些影响主要发生在长期使用之后，因此引发了一个问题，即一氧化二氮是否具有成瘾性，从而解释了其高剂量的长期和频繁使用。文献中可以找到一些关于一氧化二氮依赖责任的证据，但作用机制仍存在争议。一氧化二氮与阿片样物质系统相互作用，但一氧化二氮也作为 N-甲基-D-天冬氨酸（NMDA）受体拮抗剂，通过其可以引起多巴胺去抑制。在本综述中，我们详细描述了动物和人类证据，证明了一氧化二氮引起的滥用/依赖和神经毒性。
