This trial is evaluating whether Nitrous Oxide will improve 1 primary outcome in patients with Obsessive-Compulsive Disorder. Measurement will happen over the course of 1 week.
This trial requires 45 total participants across 2 different treatment groups
This trial involves 2 different treatments. Nitrous Oxide is the primary treatment being studied. Participants will all receive the same treatment. Some patients will receive a placebo treatment. The treatments being tested are in Phase 2 and have already been tested with other people.
Many OCD patients receive medication and are offered cognitive therapy. Medication with fluoxetine and antidepressant medication have been shown to be effective in treating OCD. CBT has not been systematically reported for OCD, but it can be useful. No studies have tested the efficacy of CBT for OCD.
Symptoms of OCD may include thoughts of guilt or fear, trouble concentrating, and trouble in going to the bathroom for 5+ minutes. Symptoms are often exacerbated by stress. There is a possibility that a family history of OCD exists, but otherwise, OCD cannot be diagnosed without seeing signs and symptoms. There is no cure for OCD, just treatment.
Obsessive-compulsive disorder is a common mental health disorder characterised by a number of clinically relevant characteristics, especially intrusive obsessions and compulsive behaviours. Nearly 3% of the population develop OCD in their lifetime. In the USA, this condition affects about 1 in 10 people.
Approximately one quarter of people in the United States are diagnosed with OCD at some point in their lives although rates of OCD have declined recently.
OCD cannot be cured. There has been controversy regarding what constitutes a cure for OCD. While patients usually report that their symptoms have improved, little is known about their subjective perspective as to whether or not their symptoms have changed.
Current studies have yielded many theories about what is the underlying cause of OCD. Some of these hypotheses include the possibility that a genetic vulnerability predisposes to the onset of OCD, that OCD is caused by a dysfunction in the brain that has environmental implications, or both. Some other theories are that OCD is the result of an inappropriate response to a specific environmental event or that OCD is caused by one of the psychological dimensions of OCD. Finally, some researchers think that there may be just one, common etiological mechanism for OCD that influences different clinical manifestations of OCD and that OCD may develop without any particular causal factor, but that it is accompanied by an underlying neurological dysfunction.
Nitrous oxide appeared to have no significant negative effects on cognitive functions after administration in this study. While this may not necessarily be the case in more prolonged exposures; this lack of clear impairment may be a contributing factor to its continued widespread use in anesthetized people.
Nitrous oxide is frequently used for relaxation and anticipatory sedation. When used as an adjunct to other behavioral interventions, there tends to be an increase in sessions completed by a greater percentage of participants (and a greater percentage of sessions in which the dose is reduced).
Findings from a recent study, the subjective effects of nitrous oxide were more similar to those of alcohol. Nitrous oxide was more addictive than ethanol in this cohort, a finding that may be important to account for when considering the use of non-sedation in future clinical trials.
The development of anti-obsessional agents was an important advance. Current therapies include both pharmacological and behavioural interventions; there also remains considerable research into non-pharmacological treatments.
Nitrous oxide in high levels can produce profound mental and emotional changes in only a fraction of the population. The current body of evidence suggests that nitrous oxide is a depressant and can be dangerous in clinical scenarios in which there is insufficient time for other agents to take effect. Some have expressed their willingness to take NO as an adjunct to general anesthesia in surgical settings. Nitrous oxide is not an antidote to alcohol or to opioids. The most likely safe level of nitrous oxide concentration is unknown. Further research is needed to establish a safe level of nitrous oxide in both dental and ambulatory surgery environments.
With the use of N(2)O, patients with OCD experienced significant improvements in quality of life, and this was particularly true of the cognitive domains. The effect appears to be more stable 6 months after discontinuation of N(2)O in the real world.