Severe Panic/Anxiety after Nitrous Oxide administration

I underwent nitrous oxide for a dental implant surgery 2 years ago.  The day following the surgery, I began having severe panic attacks and anxiety.  I did have some anxiety problems before the surgery but had never suffered a panic attack previously.  I am now taking medication for this anxiety that still hasn't subsided following this surgery.

I have read in some places that N2O is contraindicated for those with anxiety/mental disorders, and others that say it is not.  Is anyone familiar with this and could offer an answer?
Thank you.

[Jerome Tsang, DDS]

N2O is fine for patients who are anxious as its indicated to help relieve anxiety.  The problem with nitrous oxide is that it can make you into an altered state where your not in complete control of your senses and actions, which can be a problem with people who have a mental disorder.  If they have a disorder in which they're already having difficulty with being in reality, it can further cause problems for them to control themselves.

[Red_Star]

Nitrous oxide is a known cause of depleting vitamin B12 levels. Anxiety and panic attacks are symptoms of vitamin B12 deficiency.  Anxiety and panic attacks are also symptoms of magnesium deficiency.  Any type of physical or mental stress (including surgery) depletes magnesium levels.  Worth trialing sublingual (under the tongue) B12 and chelated magnesium supplements.  Do not take magnesium if you have heart or kidney problems.  

[ashrenmar]

Thank you, I've been doing a lot of research concerning B12.  Do you have any sources that cite the information given?  I can't seem to find much out there concerning B12 and anxiety, and I only found one article the Journal of the American Medical Association from 1986 (25 years ago!) that says N2O is dangerous in patients with B12 .

[ashrenmar]

My anxiety was not nearly that severe at the time.  It was primarily social anxiety, nervous in new situations and around new people.  

I did, however, begin to feel very uncomfortable immediately after inhalation of the N2O.  It did not relax my body but rather agitated it a bit.  It put me in a state of altered reality as it is supposed to, which helped me deal with that discomfort and helped me get through the surgery.

I hope this further information helps, and I appreciate your response.

[Red_Star]

Heseker H et al. Psychological disorders as early symptoms of mild-moderate vitamin deficiency. Ann NY Acad Sci 669:352--7, 1992

"When cobalamin levels of more than 1,000 healthy young men were studied, those who were chronically borderline vitamin B12-deficient were significantly more anxious at the time of the study--although they were not customarily nervous individuals."

U K Misra and J Kalita. Comparison of clinical and electrodiagnostic features in B12 deficiency neurological syndromes with and without antiparietal cell antibodies - Postgrad Med J. 2007 February; 83(976): 124--127.

This study results states the following....

"Cognitive impairment was associated with behavioural abnormalities in 33% of patients. The behavioural abnormalities included irritability in 10, hallucination in five, depression in four, obsession, aggression and anxiety in two each and delusion in one patient."

Another book with information on vitamin B12 deficiency: Could It Be B12?: An Epidemic of Misdiagnoses by Sally M. Pacholok RN and Jeffrey J. Stuart DO. I recall one chapter on patients showing neurological symptoms of B12 deficiency months after exposure to nitrous oxide.

[ashrenmar]

thank you, thank you, thank you!!