Easing Anxiety, Depression, OCD and Panic Attacks with Inositol

Published on March 30, 2015 by Dr. Colin O'Brien

Mood disorders come in a wide variety of presentations and have many different symptoms. However, they all tend to have overlapping symptoms as well – so it is not uncommon for someone with anxiety to also have depression, or someone with obsessive-compulsive disorder (OCD) to also experience panic attacks. So doesn’t it make sense to use nutrients that positively affect multiple neurotransmitters and many mood disorders instead of an agent that is specific for one condition? Of course it does.
Aside from exercise and diet modification, one of the greatest interventions for any type of mood disorder is inositol. Once you understand how it works in our brain, you’ll see why it can be used for all sorts of mood imbalances.

What is Inositol and how does it work?
Inositol is a lesser-known nutrient in the B-vitamin family. It is a key component of cellular membranes and, as such, it is involved in sending signals between cells. Specifically, inositol increases the sensitivity of various receptors. This is extremely important when we consider how cells talk to one another. In the most basic sense, one cell releases a chemical (a “message”) that is delivered to another cell to tell it to perform an action. Yet, if the second cell cannot receive the message, the chemical is useless. This is where we rely on the work of inositol to prepare the receptor to catch that message.
Let’s look at an example: Serotonin is one of our “happy” chemicals and is also the main neurotransmitter in the brain targeted by anti-depressant drugs. Selective serotonin reuptake inhibitors (SSRI’s) prevent the breakdown of serotonin and, therefore, increase the amount of serotonin capable of activating the receptor. In theory, more serotonin means a better mood. But what if the brain already has enough serotonin and it’s just that the receptor isn’t working properly? This is where inositol comes into play. It helps to receive the signal. (FYI: This action is for many different receptors too, not just serotonin receptors: hence why inositol is effective in many mood conditions and not just one!)

What are the applications of Inositol?
Given the mechanism of action behind inositol, it should come as no surprise that research has found 12-18 grams/day of inositol to be effective for depression, panic disorders and obsessive-compulsive disorder, among other mood disorders. While this is the evidence-based dosage for mood disorders, some people may still derive benefits from lower dosages. This, of course, depends on many factors surrounding personal individuality, nutritional status and other health markers. All in all, inositol can be considered as an alternative to natural health products such as St. John’s wort, 5-HTP, GABA and other mood-stabilizing agents.
Inositol is also indicated in cases of polycystic ovarian syndrome (PCOS) where insulin sensitivity is reduced, blood sugar levels are poorly managed, and ultimately, fertility is affected. Research has found that much lower dosages of inositol (such as 1-4 grams per day) can be used to effectively regulate insulin receptor sensitivity and positively impact many symptoms of PCOS.

Are there various forms of Inositol?
Inositol exists within the body as either myo-inositol or d-chiro-inositol, yet myo-inositol is most abundant in the central nervous system. For this reason, most research for the mood balancing effects of inositol has been done using the myo form. The D-chiro form, on the other hand, has typically been viewed as best for PCOS and blood sugar regulation. While some people reason that only the d-chiro form is valuable for PCOS, recent research has actually challenged this notion and found that each form has distinctive benefits for treating factors related to PCOS. In fact, one clinical trial suggests that a combination of both forms in a physiological ratio (40:1 in favor of myo) may be best for infertility. In any case, myo-inositol has been proven effective for the treatment of mood disorders.

Safety
Inositol is extremely safe. Still, it is important to slowly and gradually increase the dose in some individuals in order to prevent the unwanted side effect of diarrhea. While this is a relatively rare concern, it is one that people tend to want to avoid. By gradually increasing and dividing the daily dosage, this will alleviate the unpleasant effect. Additionally, inositol is contraindicated in pregnancy and, as always, if you are taking other medications then speak with your health care practitioner before supplementing with inositol.

Image by © 2015 Rostislav Sedlacek via DollarPhotoClub

References:

Benjamin J et al. Double blind placebo controlled crossover trial of inositol treatment of panic disorders. Am J Psychiatry 1995; 52: 1084-1086

Fux M et al. Inositol treatment of obsessive-compulsive disorder. Am J Psychiatry 1996; 53: 1219-1221

Levine J et al. Double blind controlled trial of inositol treatment of depression. Am J Psychiatry 1995; 152: 792-794

Nick GL. Inositol: a scientific evaluation of its clinical effectiveness. 2000