It is important when you are talking about Oxytocin to be aware of the controversies that surround it. A big question that is frequently asked is, “Does it get to the brain?”. We now know that intranasal Oxytocin does get to the brain. Intranasal Oxytocin gets to the brain via olfactory and trigeminal nerve fibers. Intravenous oxytocin does not get to the brain unless you are using higher doses, but with higher doses vasopressin receptors can be activated. This is probably why we have had minimal success in our clinic with subcutaneous Oxytocin, though we were more focused on injury treatment initially with oxytocin. That can be another discussion at some point on the forum.
Another question frequently asked is, “Does Oxytocin work the same for everyone?”.  A lot of research has been done on this question and the answer is no. There is no guarantee that Oxytocin will have the same effect on everyone. Some people do see an enhancement in their social behavior and others do not.
Dosing:
There is no “one shoe fits all” dosing for Oxytocin. The most common dose referenced in the literature for intranasal is 24IUs . There have been studies done that showed a dose as low as 8 IUs was effective. In clinical practice with dosing of 6 IU’s to 40 IUs has been used. Clinically dosing from 6 to 12 IU’s seems to be effective for mild anxiety as a standalone. Magnesium Threonate 1000-1500mg is used in conjunction for added calming effect.  It is all over the board with the intranasal application in clinical practice.
Starting with a lower dose and titrating up should be considered. Doing this ensures you do not pass up a dose that is effective for the patient. When starting Oxytocin with a patient it is important to mention the potential for the undesirable side effects i.e. aggression, anti-social behaviors and so forth.
Here is a really great article that discusses intranasal oxytocin that is worth the read. It discusses the Advances in the field of Intranasal Oxytocin: Quintana, Daniel S., Alexander Lischke, Sally Grace, Dirk Scheele, Yina Ma, and Benjamin Becker. “Advances in the Field of Intranasal Oxytocin Research: Lessons Learned and Future Directions for Clinical Research.” Molecular Psychiatry 26, no. 1 (January 2021): 80–91. https://doi.org/10.1038/s41380-020-00864-7.
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