Reimagining Oxytocin: Pharmacologic and Precision Delivery Strategies for Complex Pain and Psychiatric Conditions

Oxytocin, a neuropeptide traditionally associated with parturition and lactation, has emerged as a potential neuromodulator with therapeutic implications in pain and psychiatric disorders. Recent advances in intranasal drug delivery have enabled direct access of oxytocin to the central nervous system, bypassing the blood-brain barrier. This has prompted investigation into its use for migraine, anxiety, tinnitus, and chronic pain conditions. Preclinical and early-phase clinical studies suggest that intranasal oxytocin can e nociceptive signaling, reduce calcitonin gene-related peptide (CGRP) release, and modulate amygdala-driven emotional responses. While promising, these findings require cautious interpretation due to inconsistent clinical data, sex-specific receptor expression, and a lack of long-term safety profiles. This review synthesizes recent evidence on the mechanisms and applications of intranasal oxytocin for neuropsychiatric and somatosensory disorders, with emphasis on migraine pathophysiology, fibromyalgia, anxiety, and emerging delivery technologies.