Neurological damage from recreational use of nitrous oxide cannot always be reversed with vitamin B₁₂, specialists warn.

The team from the Royal Melbourne Hospital examined the records of 13 patients who presented with neurological symptoms from abuse of mini-cannisters of nitrous oxide (N₂O) – known as nangs – between 2017 and 2021.

They reported on a significant finding of toxicity independent of vitamin B₁₂ metabolism, which underscored the public health threat posed by abuse and the need for harm minimisation measures, they said.

Publication of their findings comes as the TGA moves to create a Schedule 6 listing for N₂O used for non-therapeutic purposes and to apply warning labels to canisters sold for whipping cream, rather than banning them.