Abstract
Fibromyalgia is a pain disorder associated with frequent comorbid mood, anxiety, and sleep disorders. Despite the frequent use of a complex, poly-drug pharmacotherapy, treatment for fibromyalgia is of limited efficacy. Oxytocin has been reported to reduce the severity of pain, anxiety, and depression, and improve the quality of sleep, suggesting that it may be useful to treat fibromyalgia. To evaluate this hypothesis, 14 women affected by fibromyalgia and comorbid disorders, assuming a complex pharmacotherapy, were enrolled in a double-blind, crossover, randomized trial to receive oxytocin and placebo nasal spray daily for 3 weeks for each treatment. Order of treatment (placebo–oxytocin or oxytocin–placebo) was randomly assigned. Patients were visited once a week. At each visit, the following instruments were administered: an adverse drug reaction record card, Visual Analog Scale of Pain Intensity, Spielberger State Anxiety Inventory, Zung Self-rating Depression Scale, and SF-12. Women self-registered painkiller assumption, pain severity, and quality of sleep in a diary. Unlikely, oxytocin nasal spray (80 IU a day) did not induce positive therapeutic effects but resulted to be safe, devoid of toxicity, and easy to handle.
References
Arnold LM, Clauw DJ, McCarberg BH (2011) Fibro collaborative. Improving the recognition and diagnosis of fibromyalgia. Mayo Clin Proc 86:457–464
Consoli G, Marazziti D, Ciapparelli A, Bazzichi L, Massimetti G, Giacomelli C et al (2012) The impact of mood, anxiety, and sleep disorders on fibromyalgia. Compr Psychiatry 53:962–967
Mease PJ, Dundon K, Sarzi-Puttini P (2011) Pharmacotherapy of fibromyalgia. Best Pract Res Clin Rheumatol 25:285–297
Carta M, Ruggiero V, Sancassiani F, Cutrano F, Manca A, Peri M et al (2013) The use of antidepressants in the long-term treatment should not improve the impact of fibromyalgia on quality of life. Clin Pract Epidemiol Ment Health 9:120–124
Stevens FL, Weisman O, Feldman R, Hurley RA, Taber KH (2013) Oxytocin and behavior: evidence for effects in the brain. J Neuropsychiatry Clin Neurosci 25:96–102
Rash JA, Aguirre-Camacho A, Campbell TS (2013) Oxytocin and pain: a systematic review and synthesis of findings. Clin J Pain [Epub ahead of print]
Melis MR, Argiolas A (2011) Central control of penile erection: a re-visitation of the role of oxytocin and its interaction with dopamine and glutamic acid in male rats. Neurosci Biobehav Rev 35:939–955
Yang J, Li P, Liang JY, Pan YJ, Yan XQ, Yan FL, Hao F et al (2011) Oxytocin in the periaqueductal grey regulates nociception in the rat. Regul Pept 169:39–42
Condés-Lara M, Maie IA, Dickenson AH (2005) Oxytocin actions on afferent evoked spinal cord neuronal activities in neuropathic but not in normal rats. Brain Res 1045:124–133
Yang J (1994) Intrathecal administration of oxytocin induces analgesia in low back pain involving the endogenous opiate peptide system. Spine 19:867–871
Madrazo I, Franco-Bourland RE, León-Meza VM, Mena I (1987) Intraventricular somatostatin-14, arginine vasopressin, and oxytocin: analgesic effect in a patient with intractable cancer pain. Appl Neurophysiol 50:427–431
Guastella AJ, Hickie IB, McGuinness MM, Otis M, Woods EA, Hannah M et al (2013) Recommendations for the standardization of oxytocin nasal administration and guidelines for its reporting in human research. Psychoneuroendocrinology 38:612–625
van Ijzendoorn MH, Bhandari R, van der Veen R, Grewen KM, Bakermans-Kranenburg MJ (2012) Elevated salivary levels of oxytocin persist more than 7 h after intranasal administration. Front Neurosci 6:174
Lawrance D (2002) Intranasal delivery could be used to administer drugs directly to the brain. Lancet 359:1674
Scantamburlo G, Ansseau M, Geenen V, Legro JJ (2011) Intranasal oxytocin as an adjunct to escitalopram in major depression. J Neuropsychiatry Clin Neurosci 23:E5
Guastella AJ, Howard AL, Dadds MR, Mitchell P, Carson DS (2009) A randomized controlled trial of intranasal oxytocin as an adjunct to exposure therapy for social anxiety disorder. Psychoneuroendocrinology 34:917–923
Bartz J, Simeon D, Hamilton H, Kim S, Crystal S, Braun A et al (2011) Oxytocin can hinder trust and cooperation in borderline personality disorder. Soc Cogn Affect Neurosci 6:556–563
Perry A, Bentin S, Shalev I, Israel S, Uzefovsky F, Bar-On D et al (2010) Intranasal oxytocin modulates EEG mu/alpha and beta rhythms during perception of biological motion. Psychoneuroendocrinology 35:1446–1453
Anderberg UM, Uvnäs-Moberg K (2000) Plasma oxytocin levels in female fibromyalgia syndrome patients. Z Rheumatol 59:373–379
Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL et al (1990) The American College of rheumatology. Criteria for the classification of fibromyalgia. Report of the multicenter criteria committee. Arthritis Rheum 33:160–172
Spielberg CD (1983) Manual for the state-trait anxiety inventory. Consulting Psychologists Press, STAI (Form Y) Palo Alto, CA
Zung WW (1965) A self-rating depression scale. Arch Gen Psychiatry 12:63–70
Ware J Jr, Kosinski M, Keller SD (1996) A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care 34:220–233
Huskisson EC (1983) Visual analog scale. In: Melzack R (ed) Pain measurement and assessment. Raven, New York, NY
Feifel D, MacDonald K, Nguyen A, Cobb P, Warlan H, Galangue B et al (2010) Adjunctive intranasal oxytocin reduces symptoms in schizophrenia patients. Biol Psychiatry 68:678–680
Acknowledgments
The authors express gratitude to Defiante/Sigma-Tau Industrie Farmaceutiche Riunite S.p.A. for supplying oxytocin and placebo nasal spray. The authors express also sincere gratitude to Sandra Bargone, Paolo Chillotti, Valentina Collu, Marinella Corona, Maria Francesca Gessa, and Valentina Giglio, the nurse staff of the Pain Therapy Unit of the “A. Businco” Hospital, ASL 8, Cagliari, Italy, for their active and valid contributions, to Dr. Gisella Carrucciu for pharmaceutical assistance, and to Mrs. Anne Farmer for language editing of the manuscript.
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The authors have no financial or non-financial conflict of interest to declare.
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S. Mameli and G. M. Pisanu have equally contributed to this work.
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Mameli, S., Pisanu, G.M., Sardo, S. et al. Oxytocin nasal spray in fibromyalgic patients. Rheumatol Int 34, 1047–1052 (2014). https://doi.org/10.1007/s00296-014-2953-y
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DOI: https://doi.org/10.1007/s00296-014-2953-y