Cyanocobalamin: A Case for Withdrawal

The use of Vitamin B12b in Psychiatric Practice

“…In England, Foulds and others (1970) 24 have started a movement to remove the conventional form of vitamin B 12 (cyanocobalamin) from the market. These authors feel that the cyanide radical is toxic for some patients and has produced optic nerve atrophy.…”

Continuous ventilation and oedema.

“…Severe anaemia conferred "protection" from neurological complications, and it is usually accepted that the adverse neurological effects of treating pernicious anaemia with folic acid occur after the haematological remission.' Administration of folic acid lowered serum-vitamin-B12 levels in patients on anticonvulsants.6 Leber's hereditary optic atrophy may result from a defect in the detoxication of cyanide as well as retrobulbar neuritis of vitamin-B12 deficiency and tobacco amblyopia.7 Hydroxocobalamin has been superior to cyanocobalamin in the treatment of these cases7 8 Remarkably, toxic amblyopia has also been reported from phenytoin.9 Phenytoininduced neuropathy has been unresponsive to folic acid supplements. Thus an interference with the cyanide metabolism can be postulated to play a part in the neuropsychiatric side effects of phenytoin in some patients.…”

Nocturia during steroid therapy.

“…The interesting feature of this case lies in the fact that peripheral oedema and ascites developed so rapidly while the child was having intermittent positive pressure ventilation. This treatment has been employed in adult patients with poliomyelitis over much longer periods of time in our special care unit, Peripheral oedema and ascites have not been seen there.-I am, etc., K .. .. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] (1-015) [1][2][3][4][5][6][7][8][9][10][11][12] (1-016)…”