Future directions for the investigation of intranasal oxytocin and pain: Comment on: Oxytocin nasal spray in fibromyalgic patients (Rheumatol Int. E-pub ahead of print. doi: 10.1007/s00296-014-2953-y).

Abstract

ratings was not indicated. Many aspects of the oxytocin–pain association are not yet well understood. For instance, it is unclear whether elevations in plasma and/or central oxytocin levels have analgesic properties (see []), which 3pain modalities are most responsive to oxytocin (e.g., acute, intermittent, chronic), or the duration of effects (e.g., minutes to hours). Careful documentation of admin-istration procedures may provide insight into answering these important questions.Mameli et al. [1] suggest that future trials use a dose of oxytocin that exceeds 80 IU. Caution is warranted as most research assessing intranasal oxytocin has used doses rang-ing between 16 and 48 IU, and lower doses may yield more fruitful results. For example, stronger effects of a 24-IU dose of intranasal oxytocin on the cortisol response to intense exercise were reported than for a 48-IU dose [4]. there may exist a dose threshold above which no further intranasal oxytocin can be absorbed. For instance, a 16-IU dose of intranasal oxytocin resulted in similar salivary con-centrations following a 7-h duration as did a 24-IU dose [5]. Dose–response investigations are needed to determine dose optimization.this trial was powered to detect large effects, and the results are inconclusive. A minimum detectable Cohen’s