When Depression Has Not Responded to Other Treatments
People living with depression may continue to experience symptoms after trying medication, therapy, or other established forms of care. Nitrous oxide treatment provides a different clinical approach for select patients.
Midwest Institute for Hearts and Minds provides physician-administered nitrous oxide treatment at our St. Louis clinic. Every patient begins with an in-person consultation to discuss their health history and whether nitrous oxide treatment may be helpful.
Learn More About Nitrous Oxide Treatment for Depression
To discuss whether nitrous oxide treatment is an appropriate next step for you, schedule a consultation with MIHAM or call (314) 270-4248.
How Nitrous Oxide Treatment Works
Nitrous oxide is a colorless, odorless gas that has been used as an anesthetic in medical and dental care for more than 150 years. MIHAM uses a controlled mixture of nitrous oxide and oxygen off-label to treat depression.
Off-label treatment means that physicians use an approved medication or anesthetic for a condition outside its original FDA-approved indication based on clinical evidence, medical judgment, and the patient’s needs.
Physician-Administered Treatment
You breathe a controlled mixture of nitrous oxide and oxygen through a mask while a MIHAM physician administers and supervises the treatment.
Initial Treatment Plan
The initial series includes three treatments completed over one week. Patients who respond well may receive additional maintenance treatments based on their symptoms and the physician’s recommendation.
Appointment Length
Each nitrous oxide treatment lasts approximately one hour, with additional time allowed for preparation and monitoring.
Response Tracking
MIHAM tracks changes in mood and daily function throughout treatment to gauge patient response.
Who is a Candidate for Nitrous Oxide?
Nitrous oxide treatment is intended for certain patients with depression. Our physicians consider a patient’s diagnosis and symptoms, treatment history, current medications, overall health, and ongoing mental healthcare when determining whether to recommend nitrous oxide.
Potential candidates often identify with several of the following:
- You have received a depression diagnosis and continue working with a mental healthcare provider.
- Your depression symptoms have persisted despite medication, therapy, or other established forms of care.
- Previous antidepressant treatments provided limited improvement or relief that did not last.
- You are interested in exploring a different treatment approach under medical supervision.
To determine whether nitrous oxide is appropriate for you, MIHAM invites you to the clinic for a consultation with a physician. During this approximately 90-minute appointment, a MIHAM physician reviews your health history, current medications, previous treatments, depression symptoms, and ongoing mental healthcare before determining whether treatment is appropriate.
If the physician recommends treatment, the MIHAM team will explain and schedule the initial three-session series. Eligible patients are also invited to participate in a study being conducted by Washington University physicians in partnership with our clinic.
Why Researchers Are Studying Nitrous Oxide for Depression
Nitrous oxide blocks NMDA receptors involved in glutamate signaling. Because this differs from the pathway targeted by many traditional antidepressants, researchers have studied whether nitrous oxide produces a faster antidepressant response in people whose symptoms have not improved enough with established treatment.
What an Earlier Washington University Study Found
A 2021 phase 2 trial of nitrous oxide for treatment-resistant depression involved researchers from Washington University and the University of Chicago. The study included 24 patients who received separate one-hour sessions using 25% nitrous oxide, 50% nitrous oxide, and a placebo mixture of air and oxygen.
Both concentrations of nitrous oxide reduced depression symptoms compared with placebo. The 25% concentration produced results comparable to the 50% concentration while causing substantially fewer adverse effects. Improvements following treatment remained measurable for up to two weeks.
The Current Washington University Observational Study
Washington University is now studying how long the antidepressant response to nitrous oxide lasts. Patients begin through MIHAM, where a physician completes the consultation and screening, determines whether treatment is appropriate, and administers each nitrous oxide session.
If the physician recommends treatment, eligible patients may choose whether to participate in the Washington University study. Participation is entirely voluntary. Declining the study does not affect access to treatment or the introductory treatment rate.
What to Expect During Nitrous Oxide Treatment
The initial treatment series includes three one-hour sessions over the course of one week. A MIHAM physician administers each treatment, and the clinical team tracks your response throughout the series.
Step 1: Preparing for Treatment
After a MIHAM physician recommends nitrous oxide treatment, our team schedules your initial series and explains how to prepare for each appointment.
Step 2: Receiving Nitrous Oxide
During each session, you breathe a controlled mixture of nitrous oxide and oxygen through a mask for approximately one hour. A MIHAM physician at our St. Louis clinic administers the treatment and monitors your blood pressure, heart rate, and oxygen level.
Some patients may experience mild nausea or dizziness with nitrous oxide. These possible effects are temporary and clear on their own after the treatment ends.
Step 3: After Each Treatment
Our staff provides instructions related to recovery, transportation, and activities following your appointment.
Follow the instructions provided by the clinic and contact our team if you have questions before your next scheduled treatment.
Step 4: Follow-Up
After the initial series, your physician reviews your symptoms and treatment experience. Patients who respond well may receive additional maintenance treatments based on their symptoms and the physician’s recommendation.
Nitrous Oxide Treatment Cost in St. Louis
To make this emerging therapy available to more patients, MIHAM offers the initial three nitrous oxide treatments at a special rate of $150 per session, for a total of $450.
Initial treatment series: The initial plan includes three one-hour treatments completed over one week at $150 per session.
FAQs About Nitrous Oxide Treatment for Depression
These answers cover off-label treatment, the Washington University study, side effects, medications, treatment cost, and response timing.
Is nitrous oxide treatment the same as laughing gas?
Nitrous oxide is commonly known as laughing gas and has been used as an anesthetic in medical and dental care for more than 150 years. For depression treatment, patients breathe a controlled mixture of nitrous oxide and oxygen through a mask while a MIHAM physician administers and supervises the session.
Is nitrous oxide FDA-approved for depression?
No. Nitrous oxide is used as an anesthetic in medical care, but its use for depression is off-label. Off-label treatment means that a physician uses an approved medication or anesthetic for a condition outside its original approved indication based on clinical evidence, medical judgment, and the patient’s needs.
Does Washington University provide nitrous oxide treatments?
No. MIHAM physicians screen patients, recommend treatment, and administer every nitrous oxide session. Washington University researchers record mood and treatment response among qualifying study participants in virtual appointments but do not direct or provide treatment.
Do I have to participate in the Washington University study?
No. Study participation is entirely voluntary and is discussed only after a MIHAM physician recommends nitrous oxide treatment. You may receive treatment at the same introductory rate whether or not you participate in the study.
What are the side effects of nitrous oxide treatment?
Experiences differ, but temporary effects may include:
- Dizziness or lightheadedness
- Tiredness or drowsiness
- Nausea
- Headache
Can I receive nitrous oxide treatment while taking antidepressants?
Yes. Many patients explore nitrous oxide treatment while continuing medication and other depression care. The MIHAM physician reviews your medications and provides treatment-specific instructions. Do not stop or change prescribed medication without guidance from the healthcare professional managing it.
How much does nitrous oxide treatment cost?
MIHAM offers the initial three nitrous oxide treatments at a special rate of $150 per session. The same introductory rate applies whether or not you participate in the Washington University study.
Patients who respond well may receive additional maintenance treatments based on their symptoms and the physician’s recommendation. MIHAM discusses the current cost of maintenance treatment before scheduling additional sessions.
Does nitrous oxide treatment work for depression?
Clinical studies have reported reductions in depression symptoms among some patients, including people whose symptoms had not improved enough with established antidepressant treatment. Response differs by patient, and researchers continue studying how long the antidepressant effect lasts.
How quickly does nitrous oxide work for depression?
Clinical studies have reported changes in depression symptoms within hours or days of treatment for some patients. Timing and improvement differ by patient, so the MIHAM physician evaluates your response across the initial three-treatment series rather than judging the outcome from one appointment.
Why Choose MIHAM for Nitrous Oxide Treatment?
Nitrous oxide treatment for depression requires thoughtful screening, physician oversight, and continued evaluation of your response. MIHAM manages each part of that process at our St. Louis clinic.
- MIHAM is the primary provider of nitrous oxide treatment for depression in the St. Louis area.
- Meet face-to-face with a physician during a consultation.
- Receive an individualized treatment recommendation based on your symptoms, health, medications, and previous depression care.
- Have each treatment administered by a MIHAM physician.
- Begin with three one-hour treatments offered at an introductory rate of $150 per session.
- Choose whether to participate in the voluntary Washington University observational study.
- Receive continued mood tracking and follow-up as the physician evaluates your response.
The first step is an in-person consultation at our South County clinic. The appointment gives you time to discuss nitrous oxide treatment, your depression history, and your questions directly with a physician before deciding whether to move forward.
To discuss nitrous oxide treatment in St. Louis, contact MIHAM or call (314) 270-4248.