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Hyperbaric Oxygen Therapy for Adults with Mental Illness: A Review of the Clinical Effectiveness

Rapid Response Report: Summary with Critical Appraisal

Mental illness, including major depressive episode, bipolar disorder, generalized anxiety disorder, alcohol abuse, and other drug abuse or dependence, affects approximately 1 in 3 Canadians at some point in their lives. Depression is the most common mood disorder, with a lifetime incidence of 11.3%, while the lifetime incidence of generalized anxiety disorder is 8.7%.

Hyperbaric oxygen therapy (HBOT) is administered inside a treatment chamber and provides the patient with 100% oxygen at high atmospheric pressures. There have been a number of medical conditions in which treatment with hyperbaric oxygen has been investigated, including, but not limited to, treatment of carbon monoxide poisoning, improved wound healing, and decompression sickness and air embolism due to ascending too quickly in aviation or deep water diving. It has been hypothesized that hyperbaric oxygen therapy may be beneficial in the treatment of certain mental health disorders such as post-traumatic stress disorder occurring in the setting of a traumatic brain injury. In an uncontrolled pre-post study, a group of patients with blast-induced post-concussion syndrome with or without post-traumatic stress disorder demonstrated improvement in a number of physical, psychological, and cognitive measured hen tested within a week of completing 30 days of HBOT. The proposed mechanism of action of hyperbaric oxygen in traumatic brain injury is that increasing oxygenation of blood and tissues to supraphysiological levels results in the improvement of neuronal functioning by the reactivation of metabolic or electrical pathways. Stem cell mobilization to sites of injury, immune modulation and impact on neurotransmitters have also been hypothesized as possible mechanisms.

Currently, the value of using hyperbaric oxygen therapy in the treatment of mental illness has not been well-established. The purpose of this report was to review existing studies on the use of hyperbaric oxygen therapy for adults with post-traumatic stress disorder, generalized anxiety disorder, or depression.

Disclaimer: The Rapid Response Service is an information service for those involved in planning and providing health care in Canada. Rapid responses are based on a limited literature search and are not comprehensive, systematic reviews. The intent is to provide a list of sources of the best evidence on the topic that CADTH could identify using all reasonable efforts within the time allowed. Rapid responses should be considered along with other types of information and health care considerations. The information included in this response is not intended to replace professional medical advice, nor should it be construed as a recommendation for or against the use of a particular health technology. Readers are also cautioned that a lack of good quality evidence does not necessarily mean a lack of effectiveness particularly in the case of new and emerging health technologies, for which little information can be found, but which may in future prove to be effective. While CADTH has taken care in the preparation of the report to ensure that its contents are accurate, complete and up to date, CADTH does not make any guarantee to that effect. CADTH is not liable for any loss or damages resulting from use of the information in the report.

Copyright © 2014 Canadian Agency for Drugs and Technologies in Health.

Copyright: This report contains CADTH copyright material and may contain material in which a third party owns copyright. This report may be used for the purposes of research or private study only. It may not be copied, posted on a web site, redistributed by email or stored on an electronic system without the prior written permission of CADTH or applicable copyright owner.

Links: This report may contain links to other information available on the websites of third parties on the Internet. CADTH does not have control over the content of such sites. Use of third party sites is governed by the owners’ own terms and conditions.

Except where otherwise noted, this work is distributed under the terms of a Creative Commons Attribution-NonCommercial- NoDerivatives 4.0 International licence (CC BY-NC-ND), a copy of which is available at http://creativecommons.org/licenses/by-nc-nd/4.0/

Bookshelf ID: NBK253746PMID: 25411676

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