Abstract

The alcohol withdrawal syndrome increases autonomic activation and stress in patients during detoxification, leading to alterations in motor activity and sleep irregularities. Intranasal oxytocin has been proposed as a possible treatment of acute alcohol withdrawal. The aim of the present study was to explore whether actigraphy could be used as a tool to register symptoms during alcohol detoxification, whether oxytocin affected actigraphy variables related to motor activity and sleep compared to placebo during detoxification, and whether actigraphy-recorded motor function during detoxification was different from that in healthy controls. This study was a part of a randomized, double blind, placebo-controlled trial in which 40 patients with alcohol use disorder admitted for acute detoxification were included. Of these, 20 received insufflations with intranasal oxytocin and 20 received placebo. Outcomes were actigraphy-recorded motor activity during 5-hour sequences following the insufflations and a full 24-hour period, as well as actigraphy-recorded sleep. Results were related to clinical variables of alcohol intake and withdrawal, including self-reported sleep. Finally, the actigraphy results were compared to those in a group of 34 healthy individuals. There were no significant differences between the oxytocin group and the placebo group for any of actigraphy variables registered. Neither were there any correlations between actigraphy-recorded motor function and clinical symptoms of alcohol withdrawal, but there was a significant association between self-reported and actigraphy-recorded sleep. Compared to healthy controls, motor activity during alcohol withdrawal was lower in the evenings and showed increased variability. Intranasal oxytocin did not affect actigraphy-recorded motor activity nor sleep in patients with acute alcohol withdrawal. There were no findings indicating that actigraphy can be used to evaluate the degree of withdrawal symptoms during detoxification. However, patients undergoing acute alcohol withdrawal had a motor activity pattern different from than in healthy controls.

Highlights

  • Increased anxiety, changes in motor activity and sleep disturbances are some of the clinical features of alcohol withdrawal syndrome (AWS), reflecting a hyper-excitatory state in the sympathetic part of the central nervous system that develops within the first 24 hours after drinking cessation [1, 2]

  • There were no significant differences between the oxytocin group and the placebo group for any of actigraphy variables registered

  • Motor activity during alcohol withdrawal was lower in the evenings and showed increased variability

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Summary

Introduction

Changes in motor activity and sleep disturbances are some of the clinical features of alcohol withdrawal syndrome (AWS), reflecting a hyper-excitatory state in the sympathetic part of the central nervous system that develops within the first 24 hours after drinking cessation [1, 2]. A growing number of trials are exploring intranasal oxytocin as a potential drug in the treatment of alcohol use disorder and substance abuse, yet so far with mixed results [13,14,15,16,17]. One pilot trial suggested that the anxiolytic effects of intranasal oxytocin may be favorable in reducing alcohol withdrawal symptoms [18]. The aim of the present study was to explore whether actigraphy could be used as a tool to register symptoms during alcohol detoxification, whether oxytocin affected actigraphy variables related to motor activity and sleep compared to placebo during detoxification, and whether actigraphy-recorded motor function during detoxification was different from that in healthy controls

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