Oxytocin therapy in hypopituitarism: Challenges and opportunities

Abstract

Summary Patients with hypopituitarism display impaired quality of life and excess morbidity and mortality, despite apparently optimal pituitary hormone replacement. Oxytocin is a neuropeptide synthesized in the anterior hypothalamus which plays an important role in controlling social and emotional behaviour, body weight and metabolism. Recent studies have suggested that a deficiency of oxytocin may be evident in patients with hypopituitarism and craniopharyngioma, and that this may be associated with deficits in cognitive empathy. Preliminary data hint at potential benefits of oxytocin therapy in improving these deficits and the accompanying metabolic disturbances that are common in these conditions. However, several challenges remain, including an incomplete understanding of the regulation and mechanisms of action of oxytocin, difficulties in accurately measuring oxytocin levels and in establishing a diagnosis of oxytocin deficiency, and a need to determine both the optimal mode of administration for oxytocin therapy and an acceptable safety profile with long‐term use. This review considers the data linking oxytocin to the neuropsychological and metabolic disturbances evident in patients with craniopharyngioma and hypopituitarism, and describes the challenges that need to be overcome before replacement therapy can be considered as a therapeutic option in clinical practice.

A Case of Postpartum Pulmonary Edema Induced by Oxytocin

“…Oxytocin is a neuropeptide hormone synthesized in the anterior pituitary and stored and released from the posterior pituitary. Oxytocin stimulates uterine contraction, cervical ripening, and dilation, and promotes clotting in the postpartum period [ 6 ]. Oxytocin is closely related to vasopressin in molecular structure and widely used for induction or augmentation of labor, prevention, and management of postpartum hemorrhage and is used as an adjunctive treatment of abortion.…”

New developments and concepts in the diagnosis and management of diabetes insipidus (AVP‐deficiency and resistance)

“…Thus, the need for replacement treatment remains mainly theoretical, although a cross‐sectional study demonstrated that low oxytocin levels were associated with lower bone mass density and less favourable hip geometry, 152 as well as with cognitive impairment. Preliminary results provide some evidence of potential benefits of oxytocin therapy with respect to improving these deficits and accompanying metabolic disturbances 153,154 . Oxytocin is currently administered as an i.v.…”

“…Preliminary results provide some evidence of potential benefits of oxytocin therapy with respect to improving these deficits and accompanying metabolic disturbances. 153,154 Oxytocin is currently administered as an i.v. preparation to induce or augment…”

Oxytocin-Induced Acute Pulmonary Edema: A Case Report and Literature Review

“…It is one of the few hormones that work by the positive feedback mechanism. Its functions include stimulation of uterine contractions as well as stimulation of the myoepithelial cells in the female breast causing milk expression [ 1 ]. In clinical practice, exogenous oxytocin is approved for use in the antepartum period to strengthen uterine contractions, to facilitate vaginal delivery of the fetus.…”