Effects of oxytocin on stress reactivity and craving in veterans with co-occurring PTSD and alcohol use disorder

Julianne C. Flanagan, Nicholas P. Allan, Casey D. Calhoun, Christal L. Badour, Megan Moran Santa Maria, Kathleen T. Brady, Sudie E. Back

Research output: Contribution to journalArticlepeer-review

27 Scopus citations


Posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) are highly prevalent and commonly co-occur. The dual diagnosis of PTSD/AUD is associated with serious negative sequalae, and there are currently no effective pharmacological treatments for this comorbidity. Both PTSD and AUD are characterized by dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, which helps modulate stress reactivity. Oxytocin, a neuropeptide that attenuates HPA axis dysregulation, may be beneficial for individuals with co-occurring PTSD/AUD. Thus, the current study examined the effects of intranasal oxytocin (40 IU) as compared with placebo on stress reactivity (e.g., cortisol) as well as subjective alcohol craving in response to a laboratory stress task (Trier Social Stress Task). Participants were 67 male U.S. military veterans with current PTSD and AUD (oxytocin n = 32, placebo n = 35; overall mean age = 49.06 years). Baseline cortisol levels were examined as a moderator of outcome. The findings revealed that oxytocin marginally attenuated cortisol reactivity in response to the stress task. Furthermore, oxytocin's effect was moderated by baseline cortisol level, such that oxytocin mitigated cortisol reactivity to a greater extent among participants with higher, as compared with lower, baseline cortisol. Oxytocin did not reduce craving. Although preliminary, the findings are the first to examine oxytocin in co-occurring PTSD/AUD. The findings from this study contribute to the growing literature examining the potential utility of oxytocin among individuals with psychiatric disorders, such as PTSD and substance use disorders.

Original languageEnglish
Pages (from-to)45-54
Number of pages10
JournalExperimental and Clinical Psychopharmacology
Issue number1
StatePublished - Feb 2019

Bibliographical note

Funding Information:
This study is registered with ClinicalTrials.gov: identifier, NCT02058251. This article is the result of work supported, in part, by the Department of Defense (W81XWH-12-2-0048), the National Institute on Alcohol Abuse and Alcoholism (K23AA023845), and the National Institute on Drug Abuse (K12DA035150). The funding sources had no other role than financial support in this study. The authors thank Justin Messinger and Alexandra Snead for their assistance collecting and entering data for this project.

Publisher Copyright:
© 2018 American Psychological Association.


  • Alcohol
  • Comorbidity
  • Craving
  • Oxytocin
  • PTSD

ASJC Scopus subject areas

  • Pharmacology
  • Psychiatry and Mental health
  • Pharmacology (medical)


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