By April Segal PharmD
Oxytocin has been called "the cuddle hormone", "the love hormone" and “the bonding hormone” due to its association with pair bonding. It appears to help reinforce the early attachment between mothers and their infants, as well as the bonds between romantic partners. Animal research has connected oxytocin with the lifelong pair-bonding in animals, and scientists have reported increases in oxytocin levels following orgasm in humans. There is also evidence that increases in oxytocin may encourage prosocial behavior.
There are a few emerging therapeutic uses of prescription oxytocin. Oxytocin is preferentially administered by injection or nasal spray since chymotrypsin, present in the GI tract, may destroy oxytocin that is taken by mouth. Oxytocin nasal spray is only available from compounding pharmacies, like Remedy.
Oxytocin Nasal Spray is commonly prescribed for the following conditions:
- Milk Letdown in Breastfeeding
- Autism Spectrum Disorder
- Female Arousal Disorder, Female Orgasmic Disorder and Delayed Orgasm in Men
- Postpartum Depression
Read below for more detail on the conditions we commonly make oxytocin nasal spray for our patients!
Autism Spectrum Disorder
Oxytocin has recently received significant interest in the Autism community. Researchers have found that autistic children have lower plasma levels of oxytocin than those of other children. In addition, oxytocin has been implicated in the etiology of autism, with one report suggesting autism is correlated with genomic deletion of the gene containing the oxytocin receptor gene (OXTR). Investigational research is being done on the use of oxytocin nasal spray in Autism Spectrum Disorder (ASD). Oxytocin has been shown to help with social bonding and with repetitive behaviors which can be seen in people with ASD.
Repetitive behavior in autism spectrum disorders may be related to abnormalities in the oxytocin system, and may be partially ameliorated by synthetic oxytocin. In a study by Hollander et al, adults with ASD showed a significant reduction in repetitive behaviors (such as the need to know, repeating, ordering, need to tell/ask, self-injury, and touching) after an oxytocin infusion compared to placebo infusion.
Recently, it has been suggested that oxytocin may also be implicated in the social deficit of autism. Social adaptation requires specific cognitive and emotional competencies and individuals with high-functioning ASD may not understand or engage in social situations despite preserved intellectual abilities. A study by Andari et al, showed that after oxytocin inhalation, patients playing a simulated game exhibited stronger interactions with the most socially cooperative partner and reported enhanced feelings of trust and preference. Also, during free viewing of pictures of faces, oxytocin selectively increased patients' gazing time on the socially informative region of the face, namely the eyes. Showing that under oxytocin, patients respond more strongly to others and exhibit more appropriate social behavior and affect, suggesting a therapeutic potential of oxytocin through its action on a core dimension of autism.
While there is more and more research supporting the short term improvements on the core symptoms of patients with ASD after oxytocin use, there is also exciting research coming out on the long term effects that continual use can have on the brain of patients with ASD.
In a double-blind, randomized, placebo-controlled study by Bernearts et al, the effects of single-dose and multiple-dose intranasal oxytocin treatment (4 weeks of daily (24 IU) administrations) on brain activity related to processing emotional states was studied. The multi-dose group induced a consistent attenuation in brain activity in terms of the bilateral amygdala, which outlasted the period of actual administrations until four weeks and one year post-treatment. Critically, participants with stronger attenuations in amygdala-activity showed greater behavioral improvements, particularly in terms of self-reported feelings of avoidant attachment and social functioning. Together, these observations provide initial insights into the long-lasting neural consequences of chronic oxytocin use on amygdala functioning and provide first indications that the acute versus chronic effects of oxytocin administration may be qualitatively different. Larger studies are however warranted to further elucidate the long-term impact of oxytocin treatment on human neural substrates and its behavioral consequences.
Female Sexual Dysfunction
Female Sexual Dysfunction is a common but under-recognized condition. Please see our blog post that delves further into this condition written by Dr. Natasha Monterey from Mosaic Integrative Medicine. Muin et al studied the use of oxytocin nasal spray on female sexual satisfaction as measured by validated scoring systems. After intranasal oxytocin (32 IU) within 50 minutes of sexual intercourse for 8 weeks the Female Sexual Function Index score increased by 26-31%, the Sexual Quality of Life - Female Score increased by 125-144%,and the Sexual Interest and Desire Inventory–Female score increased by 23-29%. They also saw a reduction in the Female Sexual Distress Scale score by 36-45%. Long-term intranasal oxytocin and placebo administration both improved sexual function and symptoms of depression in women over time with no treatment, sequence (placebo first/second), or interaction effect.
One of the most common mental disorders in the perinatal period is postpartum depression (PPD), which is associated with impaired emotional functioning due to alterations in different cognitive aspects including thought and facial emotion recognition. Donadon et al conducted a study which showed intranasal oxytocin was associated with response biases to facial happiness and the reduction of negative thoughts in mothers with PPD
The therapeutic uses of oxytocin nasal spray excites us and we look forward to further research. Oxytocin is generally well tolerated and the most common side effects are thirst, urination and constipation. Please call us today and speak to one of our knowledgeable pharmacists if you think you might benefit from oxytocin nasal spray!
- Hollander E, Novotny S, Hanratty M, Yaffe R, DeCaria CM, Aronowitz BR, Mosovich S. Oxytocin infusion reduces repetitive behaviors in adults with autistic and Asperger's disorders. Neuropsychopharmacology. 2003 Jan;28(1):193-8. doi: 10.1038/sj.npp.1300021. PMID: 12496956.
- Andari E, Duhamel JR, Zalla T, Herbrecht E, Leboyer M, Sirigu A. Promoting social behavior with oxytocin in high-functioning autism spectrum disorders. Proc Natl Acad Sci U S A. 2010 Mar 2;107(9):4389-94. doi: 10.1073/pnas.0910249107. Epub 2010 Feb 16. PMID: 20160081; PMCID: PMC2840168.
- Bernaerts S, Boets B, Steyaert J, Wenderoth N, Alaerts K. Oxytocin treatment attenuates amygdala activity in autism: a treatment-mechanism study with long-term follow-up. Transl Psychiatry. 2020 Nov 6;10(1):383. doi: 10.1038/s41398-020-01069-w. PMID: 33159033; PMCID: PMC7648620.
- Donadon M, Martin-Santos R, Osório F. Oxytocin effects on the cognition of women with postpartum depression: A randomized, placebo-controlled clinical trial. Progress in Neuro-Psychopharmacology and Biological Psychiatry. 2020. ISSN 0278-5846. https://doi.org/10.1016/j.pnpbp.2020.110098.
- Muin D, Wolzt M, Marculescu R, et al. Effect of long-term intranasal oxytocin on sexual dysfunction in premenopausal and postmenopausal women: a randomized trial. Fertility and Sterility. Volume 104, Issue 3. 2015. Pages 715-723.e4. ISSN 0015-0282. https://doi.org/10.1016/j.fertnstert.2015.06.010.