Oxytocin

[Annerose]

Hello,

I have a question about the oxytocin page on Medications & Mothers' milk online. The following is written there:
‘’However, chronic use of intranasal oxytocin may lead to dependence and should be limited to the first week postpartum.’’
Can you tell me where this advice is based on? I got a question about this but I can’t find anything in the literature about dependency for oxytocin.

Thank you in advance for your help.

[admin]

Anne:

The suggestion of dependence has been in the literature for years now. Its not a 'withdrawal type" of dependence, but rather lack of function in that the normal level of oxytocin fails. This suggests that if you use high levels of oxytocin during delivery, that the subsequent release from the pituitary may be suppressed or reduced later on.
The below paper even goes one step further, suggesting that oxytocin use may reduce breastfeeding at 2 months.

I also attached another abstract about intranasal oxytocin USE for withdrawal from other drugs. Interesting.

'll let you peruse the literature to find this data.



Tom Hale Ph.d.



J Matern Fetal Neonatal Med. ([url]https://www.ncbi.nlm.nih.gov/pubmed/24289796#[/url]) 2014 Oct;27(15):1598-603. doi: 10.3109/14767058.2013.871255. Epub 2014 Jan 13. Oxytocin administered during labor and breast-feeding: a retrospective cohort study.

GarcÃa-Fortea P ([url]https://www.ncbi.nlm.nih.gov/pubmed/?term=Garc%C3%ADa-Fortea%20P%5BAuthor%5D&cauthor=true&cauthor_uid=24 289796[/url])¹, González-Mesa E ([url]https://www.ncbi.nlm.nih.gov/pubmed/?term=Gonz%C3%A1lez-Mesa%20E%5BAuthor%5D&cauthor=true&cauthor_uid=2428 9796[/url]), Blasco M ([url]https://www.ncbi.nlm.nih.gov/pubmed/?term=Blasco%20M%5BAuthor%5D&cauthor=true&cauthor_ uid=24289796[/url]), Cazorla O ([url]https://www.ncbi.nlm.nih.gov/pubmed/?term=Cazorla%20O%5BAuthor%5D&cauthor=true&cauthor _uid=24289796[/url]), Delgado-RÃos M ([url]https://www.ncbi.nlm.nih.gov/pubmed/?term=Delgado-R%C3%ADos%20M%5BAuthor%5D&cauthor=true&cauthor_uid =24289796[/url]), González-Valenzuela MJ ([url]https://www.ncbi.nlm.nih.gov/pubmed/?term=Gonz%C3%A1lez-Valenzuela%20MJ%5BAuthor%5D&cauthor=true&cauthor_u id=24289796[/url]). Author information ([url]https://www.ncbi.nlm.nih.gov/pubmed/24289796#[/url])

Abstract

OBJECTIVE:

The relationship between labor physiology and the onset of lactation leads to assess the potential correlation between oxytocin administration during labor and duration of breast-feeding. METHODS:

This study was designed as a retrospective cohort study where patients given synthetic oxytocinduring labor induction were considered as the exposed cohort, and patients not given oxytocin formed the non-exposed cohort. Four hundred of the 7465 children born at our maternity during 2006 were randomly selected. Information about breast-feeding was available for 316 of these children. Eventual confounding or adjustment factors were analyzed using stratified and multivariate analysis. RESULTS:

Oxytocin was used for delivery of 189 (59.8%) newborns, multiplying the risk of bottle-feeding by 1.451 (95% CI 1.28-1.63). The best-fit regression model of oxytocin use effect on bottle-feeding included sex and gestational age of the newborn. The use of oxytocin also multiplies the risk of breast-feeding withdrawal at 3 months by 2.29 (95% CI 1.41-3.74). This effect is confounded by maternal age, being higher for mothers under 27 years. CONCLUSION:

Oxytocin administration during labor had some impact on both onset and duration of breast-feeding, particularly in mothers under 27 years of age and newborns delivered at term. Clinical Study registered at U.S. NIH, ID:

NCT01951040 ([url]http://clinicaltrials.gov/show/NCT01951040[/url]). KEYWORDS:

Bottle feeding; breast-feeding; cohort study; labor; oxytocin PMID: 24289796

------------------


Int Rev Neurobiol. ([url]https://www.ncbi.nlm.nih.gov/pubmed/29056153#[/url]) 2017;136:239-274. doi: 10.1016/bs.irn.2017.08.003. Epub 2017 Oct 12. Oxytocin, Tolerance, and the Dark Side of Addiction.

Pedersen CA ([url]https://www.ncbi.nlm.nih.gov/pubmed/?term=Pedersen%20CA%5BAuthor%5D&cauthor=true&cauth or_uid=29056153[/url])¹. Author information ([url]https://www.ncbi.nlm.nih.gov/pubmed/29056153#[/url])

Abstract

Substance use disorders blight the lives of millions of people and inflict a heavy financial burden on society. There is a compelling need for new pharmacological treatments as current drugs have limited efficacy and other major drawbacks. A substantial number of animal and recent clinical studies indicate that the neuropeptide, oxytocin, is a particularly promising therapeutic agent for human addictions, especially alcohol use disorders. In preliminary trials, we found that oxytocin administered by the intranasal route, which produces some neuropeptide penetration into the CNS, potently blocked withdrawal and reduced alcohol consumption in heavy drinkers. A considerable body of earlier animal studies demonstrated that oxytocin inhibits tolerance to alcohol, opioids, and stimulants as well as withdrawal from alcohol and opioids. Based on these preclinical findings and our clinical results, we hypothesize that oxytocin may exert therapeutic effects in substance dependence by the novel mechanism of diminishing established tolerance. A newer wave of studies has almost unanimously found that oxytocin decreases self-administration of a number of addictive substances in several animal models of addiction. Reduction of established tolerance should be included among the potential explanations of oxytocineffects in these studies and changes in tolerance should be examined in future studies in relationship to oxytocininfluences on acquisition and reinstatement of self-administration as well as extinction of drug seeking. Oxytocinefficacy in reducing anxiety and stress responses as well as established tolerance suggests it may be uniquely effective in reducing negative reinforcement (Koob's "dark side" of addiction) that maintains chronic substance use. KEYWORDS:

Addiction; Alcohol use disorders; Negative reinforcement; Opioid use disorders; Oxytocin; Stimulant use disorders; Substance use disorders; Tolerance PMID: 29056153

[Annerose]

Thank you very much for your response. So the use of ocytocin during laber can lead to suppressing of the milk production due to the high ocytocin levels used. I still have one question. Where is the specific advice to limit the use of oxytocin to 1 week postpartum based on? Or is this just out of precaution?