Deficiencies of members of the vitamin B complex appear to be common in patients with agoraphobia (fear of open spaces). (1) The same is likely to be true for other anxiety-related conditions. We will review the evidence suggesting that individual members of this family may affect the experience of anxiety.
Inositol is a key intermediate of the phosphatidyl-inositol cycle, a second-messenger system used by several noradrenergic, serotonergic and cholinergic receptors. (2) Since ingestion has been shown to raise inositol levels in the cerebrospinal fluid, (3) this nutrient could potentially serve as an anti-anxiety agent.
Indeed, when a group of 21 patients with panic disorder either with or without agoraphobia received 12 grams daily of inositol or placebo in random order for 4 weeks each, the inositol supplement was associated with a significantly greater reduction in the frequency and severity of panic attacks and of agoraphobia than the placebo. Moreover, while the efficacy of the nutrient was judged to be comparable to that of imipramine, its side effects were minimal. (4)
Niacinamide has been shown in an animal study to have benzodiazepine-like actions including anti-conflict, anti-aggressive, muscle relaxant and hypnotic effects. (5) In contrast to niacin, it passes readily from the plasma to the cerebrospinal fluid where it is taken up into brain cells by a high-affinity accumulation system, (6) suggesting it is the preferred form of vitamin B3 for the treatment of anxiety.
Lactate (which is associated with anxiety) reacts with niacinamide-adenine dinucleotide [NA[D.sub.+]] to form pyruvic acid and reduced NAD (NADH + [H.sup.+]). The equilibrium of this reaction favors lactate and NA[D.sup.+]), but it can be driven by adding excess NA[D.sup.+]. It...
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