Oxytocin treatment for postpartum depression
Intranasal oxytocin may aid bonding and mood in postpartum depression.
Oxytocin is a neuropeptide that has been investigated as a potential treatment for postpartum depression. Mothers with postpartum depression often show altered oxytocin system activity and difficulty bonding with their infants. Intranasal oxytocin may help these mothers feel happier and improve mother-infant bonding.
Quick Facts
- Dosage used in study
- 24IU
- Number of treatment sessions
- 2
- Reported adverse incidents
- 3
Facts from the source article.
Intranasal administration
Intranasal administration offers an alternative to oral or intravenous routes for drug delivery. This method is often preferred because it is non-invasive, does not require complicated sterile preparations, is relatively painless, and can be administered quickly by a medical doctor or sometimes by the patient. Convenience and comfort are maximized, making treatment regimens more likely to be followed. For women with postpartum depression, who may be less inclined to seek inconvenient treatment or may feel socially isolated or overwhelmed, intranasal delivery is a logical choice. The nasal cavity tissue is highly vascular and provides a large surface area for absorption, allowing quick drug onset and greater potential for the drug to reach the central nervous system without undergoing first-pass metabolism. Avoiding first-pass metabolism means more of the drug is available for treatment, and gastrointestinal discomfort and digestive side-effects are avoided. Intranasal delivery allows oxytocin to cross the blood-brain barrier, expediting it to the central nervous system and cerebrospinal fluid. Increased oxytocin levels can be detected in salivary samples after intranasal administration, and these levels can remain higher than baseline for four hours after dosage, suggesting an active response. Monitoring salivary oxytocin may help identify women at risk of or with a history of postpartum depression.
Side effects
A review of 38 randomized controlled trials indicates that short-term use of intranasal oxytocin appears to have few side-effects, with no difference compared to a placebo group. Short-term use appears equally safe in vulnerable individuals and those deemed healthy. Three adverse incidents have been reported; two were attributed to misuse of the nasal spray and one to a longer treatment regimen. The most frequently reported subjective sensation was calmness, but no detectable differences were found between oxytocin and placebo groups. Since postpartum depression is not a chronic illness, short-term intranasal oxytocin treatment may be a logical application. Potentially beneficial effects include reduced anxiety, increased trust, and increased eye gaze. Duration of treatment appears key to safety; allergic reactions, neurological disorders, and cardiovascular conditions should be considered, especially with long-term use. Oxytocin can modify heart rates and cause excessive fluid intake due to an antidiuretic effect. Intravenous oxytocin, used to induce labor and enhance lactation, can cause tachycardia, bradycardia, nausea, vomiting, headaches, and less frequently water intoxication, skin rash, or anaphylactoid reactions.
Experimentation
Research has evaluated intranasal oxytocin combined with behavioral interventions for alleviating mother-infant disturbances associated with postpartum depression. In one study, seventy-seven mothers with sub-clinical levels of postpartum depression and infants aged eight to thirty weeks were randomly assigned to receive either 24IU oxytocin or a placebo nasal spray over two sessions, in addition to mother-baby interaction coaching. Measurements were taken over three time periods, using both questionnaire data and observational data such as eye contact, positive vocalizations, and interaction quality. Significant interactions were found between the therapy and oxytocin regarding maternal behavior. Oxytocin also appeared to benefit mothers not involved in the therapy compared to those receiving placebo. Oxytocin has been linked to lowering the human stress response, which may benefit the infant-mother bond in postpartum depression. Studies from the 1980s showed that breastfeeding increases plasma oxytocin levels. In an experiment, lactating women who breastfed their infant for fifteen minutes before a Trier Stress Test exhibited less stress during the test than women who only held their infant. Rising oxytocin levels during breastfeeding may contribute to this lower stress response.
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