The Effectiveness of Intranasal Oxytocin on Addiction Severity Index and Anhedonia Symptoms in an Alcoholic Case with Oropharyngeal Cancer, a Protocol for a Single-case Experimental Design Pilot Study

Document Type : Case Report

Authors

1 Department of Psychology, Faculty of Humanities, University of Science and Culture, Tehran, Iran.

2 Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

3 Department of Psychosomatic, Taleghani Hospital, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

4 Department of Counselling, Faculty of Psychology, Arak Branch, Islamic Azad University, Arak, Iran.

5 Department of Psychology, Faculty of Psychology, Tonekabon Branch, Islamic Azad University, Tonekabon, Iran.

6 Bijan Center for Substance Abuse Treatment, Tehran, Iran.

7 Department of Psychiatry, Behavioral Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

8 Department of Psychology, Tehran Science and Research Branch, Islamic Azad University, Tehran, Iran.

Abstract

One of the goals of all pharmacological interventions aimed to increase the survival rate
of patients with alcohol-dependent oropharyngeal cancers is to decrease alcohol use. Oxytocin
is an alternative therapy for craving and alcohol management. However, the effectiveness of
oxytocin on the severity of alcohol dependence has not been evaluated. In an ABABC study with
a 6-month follow-up, during February 2015 to June 2016, a 67-year-old man with oropharyngeal
squamous cell carcinoma with comorbidity of alcohol dependence syndrome and anhedonia was
selected by Respondent-Driven sampling (RDS). The patient was treated with intranasal oxytocin
in two six-week stages (B1 and B2) and received placebo only in the other two stages (A1 and
A
2), and the follow-up results were evaluated at stage C. The data were analyzed by Generalized
Estimation Equation (GEE) and Repeated Measures Correlation (rmcorr). Primary outcomes
showed that addiction severity Index (ASI) was signifcantly reduced in fve domains of medical
status, occupational status, alcohol consumption, family status, and mental status (all p’s < 0.05).
There was no signifcant effect of treatment on legal status (all p’s > 0.05). Also, social (p <
0.05) and physical (p < 0.01) anhedonia syndrome decreased in the treatment stages. However,
these changes did not persist until the 6-month follow-up (all p’s > 0.05). Secondary outcomes
showed that there was a signifcant direct relationship between the severity of addiction and
anhedonia (rmcorr = 0.01). The fndings of this study showed that the reduction of oxytocin-induced
neurotoxic symptoms led to a decrease in the severity of addiction and an improvement in the
anhedonia syndrome.

Keywords

References

(1) Pedro C, Mira B, Silva P, Netto E, Pocinho R, MotaA, Miquel L, Miquel M, Susana E and FilomenaS. Surgery vs. primary radiotherapy in early-stage
oropharyngeal cancer. Clin. Transl. Radiat. Oncol.(2018) 9: 18–22.
(2) Faehrmann T, Zernig G and Mechtcheriakov S.Oxytocin und die suchterhaltenden Mechanismender Alkoholabhängigkeit. Neuropsychiatrie.Neuropsychiatr. (2017) 32: 1–8.
(3) Olney JJ, Marshall SA and Thiele TE. Assessmentof depression-like behavior and anhedonia afterrepeated cycles of binge-like ethanol drinking inmale C57BL/6J mice. Pharmacol. Biochem. Behav.(2018) 168: 1–7.
(4) Betka S, Gould Van Praag C, Paloyelis Y, BondR, Pfeifer G, Sequeira H, Duka T and CritchleyH. Impact of intranasal oxytocin on interoceptiveaccuracy in alcohol users: An attentional mechanism?Soc. Cogn. Affect. Neurosci. (2018) 13: 440-8.
(5) Love TM, Cranford JA, Burmeister M, WojnarM, Zucker RA, J. Brower K. Oxytocin genotypemoderates the impact of social support on psychiatricdistress in alcohol-dependent patients. AlcoholAlcohol (2017) 53: 57–63.
(6) Stevenson JR, Young KA, Bohidar AE, FrancomacaroLM, Fasold TR, Buirkle JM, Ndem JR and ChristinaSC. Alcohol consumption decreases oxytocinneurons in the anterior paraventricular nucleus of thehypothalamus in prairie voles. Alcohol Clin. Exp.Res. (2017) 41: 1444–51.23
(7) Hansson AC, Koopmann A, Uhrig S, Bühler S,Domi E, Kiessling E, Ciccocioppo R, Froemke RC,Grinevich V, Kiefer F, Sommer WH, Vollstädt-Klein
S and Spanagel R. Oxytocin reduces alcohol cuereactivity in alcohol-dependent rats and Humans.Neuropsychopharmacology (2017) 43: 1235-46.
(8) Chiamulera C, Padovani L and Corsi M. Drug discovery for the treatment of substance use disorders: novel targets, repurposing, and the need for new paradigms. Curr. Opin. Pharmacol. (2017) 35: 120–4.
(9) Pirnia B and Pirnia K. An experimental single-casedesign in effectiveness of oxytocin on reducingalcohol addiction in a patient with oropharyngealcarcinoma-the mediation role of difficulties inemotional regulation. Middle East J. Cancer (2019)10: 275-9. ‏
(10) Lago L, Bruno R and Degenhardt L. Concordanceof ICD-11 and DSM-5 definitions of alcohol andcannabis use disorders: a population survey. LancetPsychiatry (2016) 3: 673–84.
(11) Shankman SA, Funkhouser CJ, Klein DN, DavilaJ, Lerner D and Hee D. Reliability and validity ofseverity dimensions of psychopathology assessedusing the Structured Clinical Interview for DSM-5(SCID). Int. J. Meth. Psych. Res. (2017) 27: e1590.
(12) Pirnia B and Pirnia K. Comparison of twomindfulness-based cognitive therapies andacupuncture on the pain and depression indexin a case with lobular carcinoma: a single caseexperimental study. Int. J. Cancer Manag. (2018) 11: e65641.
(13) Pirnia B, Pirnia K and Zahiroddin A. Auricularacupuncture for craving in a single-subject casestudy of woman with fibromyalgia and chronicecstasy use. Iran. J. Public Health (2018) 47: 1055-7
(14) Tanious R, De TK, Michiels B, Van den NoortgateW and Onghena P. Assessing consistency in singlecase A-B-A-B phase designs. Behav. Modif. (2019)44: 518-51.
(15) Lee MR, Scheidweiler KB, Diao XX, Akhlaghi F,Cummins A, Huestis MA, Leggio L and AverbeckBB. Oxytocin by intranasal and intravenous routesreaches the cerebrospinal fluid in rhesus macaques:determination using a novel oxytocin assay. Mol.Psychiatry (2018) 23: 115-22. ‏
(16) McLellan AT, Kushner H, Metzger D, Peters R,Smith I, Grissom G, Pettinati H and Argeriou M. Thefifth edition of the addiction severity index. J. Subst.Abuse Treat (1992) 9: 199–213.
(17) Chapman LJ, Chapman JP and Raulin ML. Scalesfor physical and social anhedonia. J. Abnorm.Psychol. (1976) 85: 374–82.
(18) Bach P, Reinhard I, Bühler S, Vollstädt-Klein S,Kiefer F and Koopmann A. Oxytocin modulatesalcohol-cue induced functional connectivityin the nucleus accumbens of social drinkers.Psychoneuroendocrinology (2019) 109: 104385.
(19) Tunstall BJ, Kirson D, Zallar LJ, McConnell SA,Vendruscolo JCM, Ho CP, Oleata CS, Khom S,Manning M, Lee MR, Leggio L, Koob GF, RobertoM and Vendruscolo LF. Oxytocin blocks enhancedmotivation for alcohol in alcohol dependence andblocks alcohol effects on GABAergic transmissionin the central amygdala. Daneman R, editor. PLOSBiol. (2019) 17: e2006421.
(20) Mitchell JM, Arcuni PA, Weinstein D and WoolleyJD. Intranasal oxytocin selectively modulates socialperception, craving, and approach behavior insubjects with alcohol use disorder. J. Addict. Med.(2016) 10: 182–9.
(21) Afrisham R, Paknejad M, Soliemanifar O, SadeghNejadi S, Meshkani R and Ashtary-Larky D. Theinfluence of psychological stress on the initiationand progression of diabetes and cancer. Int. J.Endocrinol. Metab. (2019) 17: e67400.
(22) De Almeida Magalhães T, Correia D, de CarvalhoLM, Damasceno S and Brunialti Godard AL.Maternal separation affects expression of stressresponse genes and increases vulnerabilityto ethanolconsumption. Brain Behav. (2017) 8: e00841.
(23) Hillemacher T and Frieling H. Pharmacotherapeuticoptions for co-morbid depression and alcoholdependence. Expert Opin. Pharmacother. (2019) 20:547–69
Iranian Journal of Pharmaceutical Research
Volume 19, Issue 3
Summer 2020
Pages 18-23

Files

Share

How to cite

Statistics