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Lee-Cheong S, Ludgate SA, Epp TCM, Schütz CG. The effectiveness of oxytocin in the treatment of stimulant use disorders: a systematic review. Behav Pharmacol 2023; 34:381-392. [PMID: 37462158 DOI: 10.1097/fbp.0000000000000744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
OBJECTIVES The purpose of this review is to examine human study evidence on the effectiveness of oxytocin in this patient population. Despite stimulant use disorder being a major public health concern, there are no validated pharmacological treatments. Psychosocial interventions show limited effectiveness especially in the more severe cases of stimulant use disorder, whereas animal models suggest that oxytocin may be a useful treatment. METHODS A literature search using Medline, Embase, and PsychInfo was undertaken. Search results were subsequently imported into Covidence to identify relevant studies. RESULTS Six studies were included in this review, two of which were pilot studies. Although oxytocin was well tolerated across studies, no study showed a statistically significant reduction in reported cocaine use or cravings. One study suggested oxytocin increased the desire to use cocaine, although the population of participants should be taken into consideration. In contrast, one study showed a trend towards reduced self-reported cocaine use. CONCLUSION Available research does not support the use of oxytocin in the management of stimulant use disorder; however, included studies are small in sample size and limited in number. There were several noteworthy findings unrelated to this review's primary and secondary outcomes, which are of interest and warrant further research. We provide suggestions for future studies in this area of research. Considering the limited data available at this time, further studies are required before any definitive conclusions can be made regarding the use of oxytocin in stimulant use disorder management.
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Affiliation(s)
- Stephen Lee-Cheong
- Department of Psychiatry, University of British Columbia, Vancouver, BC
- Department of Psychiatry, University of Saskatchewan, Saskatoon, SK, Canada
- Department of Public Health, King's College London, Strand, London, UK
| | - Sacha A Ludgate
- Department of Psychiatry, University of British Columbia, Vancouver, BC
| | - Tanisse C M Epp
- Department of Psychiatry, University of British Columbia, Vancouver, BC
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Noël Raby W, Heller M, Milliaressis D, Jean Choi C, Basaraba C, Pavlicova M, Alschuler DM, Levin FR, Church S, Nunes EV. Intranasal oxytocin may improve odds of abstinence in cocaine-dependent patients: results from a preliminary study. DRUG AND ALCOHOL DEPENDENCE REPORTS 2021; 2:100016. [PMID: 36845891 PMCID: PMC9948893 DOI: 10.1016/j.dadr.2021.100016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 11/19/2021] [Accepted: 12/06/2021] [Indexed: 11/17/2022]
Abstract
Background Oxytocin (OT) treatment in drug addiction studies have suggested potential therapeutic benefits. There is a paucity of clinical trial studies of oxytocin in cocaine use disorders. Method This was a 6-week randomized, double-blind, outpatient clinical trial study investigating the effect of daily Intranasal Oxytocin (24 IU) on cocaine use by cocaine use disorder patients. After a 7-day inpatient abstinence induction stage, patients were randomized to intranasal oxytocin or intranasal placebo. During the outpatient phase, cocaine use disorder patients were required to present themselves to the research staff 3 times a week for witnessed randomized medication administration, to provide a urine sample for qualitative toxicology, and complete mandatory assessments, including the Time-Line-Follow Back. For the interim days, patients were given an "at-home" bottle that was weighed at each clinic visit to monitor compliance. Results Neither administration of Intranasal placebo (n = 11) or Oxytocin (n = 15) induced at least 3 weeks of continuous abstinence. However, from week 3, the odds of weekly abstinence increased from 4.61 (95% CI = 1.05, 20.3) to 15.0 (CI = 1.18, 190.2) by week 6 for the Intranasal Oxytocin group (t = 2.12, p = 0.037), though there was no significant group difference overall in the odds of abstinence over time (F1,69 = 1.73, p = 0.19). More patients on Intranasal Oxytocin dropped out (p = 0.0005). Conclusions Intranasal Oxytocin increased the odds of weekly abstinence in Cocaine patients after 2 weeks compared to PBO, but was associated with a higher dropout rate. (ClinicalTrials.gov 02,255,357, 10/2014).
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Affiliation(s)
- Wilfrid Noël Raby
- Division on Substance Abuse, Department of Psychiatry, Montefiore Medical Center, Albert Einstein College of Medicine, 1510 Waters Place, 2nd Floor, Bronx, NY 10461, United States of America
- Division on Substance Use Disorders, Department of Psychiatry, Columbia University Irving Medical Center and the New York State Psychiatric Institute, New York, NY, United States of America
- Corresponding author at: Division on Substance Abuse, Department of Psychiatry, Montefiore Medical Center, Albert Einstein College of Medicine, 1510 Waters Place, 2nd Floor, Bronx, NY 10461, United States of America.
| | - Matthew Heller
- Division on Substance Use Disorders, Department of Psychiatry, Columbia University Irving Medical Center and the New York State Psychiatric Institute, New York, NY, United States of America
| | - Demetrios Milliaressis
- Division on Substance Use Disorders, Department of Psychiatry, Columbia University Irving Medical Center and the New York State Psychiatric Institute, New York, NY, United States of America
| | - C. Jean Choi
- Division of Mental Health Data Science, New York State Psychiatric Institute, New York, NY, United States of America
| | - Cale Basaraba
- Division of Mental Health Data Science, New York State Psychiatric Institute, New York, NY, United States of America
| | - Martina Pavlicova
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, United States of America
| | - Daniel M. Alschuler
- Division of Mental Health Data Science, New York State Psychiatric Institute, New York, NY, United States of America
| | - Frances R. Levin
- Division on Substance Use Disorders, Department of Psychiatry, Columbia University Irving Medical Center and the New York State Psychiatric Institute, New York, NY, United States of America
| | - Sarah Church
- Wholeview Wellness Centers, 369 Lexington Avenue, Suite 14A, New York City, NY 10017, United States of America
| | - Edward V. Nunes
- Division on Substance Use Disorders, Department of Psychiatry, Columbia University Irving Medical Center and the New York State Psychiatric Institute, New York, NY, United States of America
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Rung JM, Horta M, Tammi EM, Perez E, Ojeda MC, Lin T, Harris G, Somerville J, Salmeron D, Beltz SE, Sandesara B, Feifel D, Ebner NC. Safety and tolerability of chronic intranasal oxytocin in older men: results from a randomized controlled trial. Psychopharmacology (Berl) 2021; 238:2405-2418. [PMID: 33982141 PMCID: PMC8115997 DOI: 10.1007/s00213-021-05862-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 04/29/2021] [Indexed: 11/30/2022]
Abstract
RATIONALE Most studies evaluating the safety and tolerability of intranasal oxytocin (OT) have not reported consistent adverse events (AEs), but they have largely focused on young men and single-dose administration. Thus, it is unclear whether these findings translate to older individuals and with longer administration periods. OBJECTIVE Extending previous work, this study investigated the safety and tolerability of chronic intranasal OT in generally healthy older men. METHODS Data were from a randomized, placebo (P)-controlled, double-blind clinical trial evaluating the effects of 4 weeks of self-administered intranasal OT (24 IU twice daily) in older adults with no major physical or cognitive impairments. Heart rate, blood pressure, urine osmolality, and serum metabolic biomarkers were obtained before and at the end of the intervention. AEs were collected during the first 3 weeks and 1 week after cessation of treatment. RESULTS Of 103 participants recruited, 95 were randomized and received the intervention (OT = 49, P = 46). OT had no significant impact on cardiovascular, urine, or serum measures. The AEs reported for both treatments were generally mild and few in number, though one participant assigned to OT and two assigned to P dropped out due to AEs. Relative to P, OT did not significantly increase the likelihood of reporting AEs, nor the number or severity of AEs reported. CONCLUSION Chronic intranasal OT appears safe and well-tolerated in generally healthy older men. These findings provide support for continued human research on potential benefits of chronic OT in older adult populations.
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Affiliation(s)
- Jillian M Rung
- Department of Psychology, University of Florida, P.O. Box 112250, Gainesville, FL, 32611, USA.
- Department of Epidemiology, University of Florida, Gainesville, FL, 32611, USA.
| | - Marilyn Horta
- Department of Psychology, University of Florida, P.O. Box 112250, Gainesville, FL, 32611, USA
| | - Erin M Tammi
- Department of Psychology, University of Florida, P.O. Box 112250, Gainesville, FL, 32611, USA
| | - Eliany Perez
- Department of Psychology, University of Florida, P.O. Box 112250, Gainesville, FL, 32611, USA
| | - Marite C Ojeda
- Department of Psychology, University of Florida, P.O. Box 112250, Gainesville, FL, 32611, USA
| | - Tian Lin
- Department of Psychology, University of Florida, P.O. Box 112250, Gainesville, FL, 32611, USA
| | - Griffin Harris
- Department of Psychology, University of Florida, P.O. Box 112250, Gainesville, FL, 32611, USA
| | - Jessie Somerville
- Department of Psychology, University of Florida, P.O. Box 112250, Gainesville, FL, 32611, USA
| | - Dinia Salmeron
- Department of Psychology, University of Florida, P.O. Box 112250, Gainesville, FL, 32611, USA
| | - Susan E Beltz
- Investigational Drug Service, University of Florida, Gainesville, FL, USA
| | - Bhanuprasad Sandesara
- Department of Aging and Geriatric Research, Institute on Aging, University of Florida, Gainesville, FL, USA
| | - David Feifel
- Department of Psychiatry, University of California, San Diego, USA
| | - Natalie C Ebner
- Department of Psychology, University of Florida, P.O. Box 112250, Gainesville, FL, 32611, USA.
- Department of Aging and Geriatric Research, Institute on Aging, University of Florida, Gainesville, FL, USA.
- Center for Cognitive Aging and Memory, Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA.
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