PRACTITIONER VIEW ONLY: Oxytocin is a nine-amino-acid peptide that is synthesised in the hypothalamus and released into the bloodstream via the pituitary gland where it plays an important role in facilitating uterine contractions during childbirth and in milk let-down. In addition, oxytocin (along with the structurally similar peptide vasopressin) is released within the brain where it plays a key role in regulating associated behaviours, such as mother–infant and adult–adult bond formation, sexual behaviour and social memory/recognition. Recent studies have also begun to investigate oxytocin’s role in various other behaviours including social recognition, orgasm, maternal behaviors, anxiety, trust, love, stress reactivity and repetitive behaviours.

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PRACTITIONER VIEW ONLY: This week I am going to discuss Bethanechol – a prescription only, choline-like substance which stimulates the parasympathetic nervous system. Bethanechol is derived from Betel nuts, and is an old drug which was originally used to treat urinary retention, stuttering and to stimulate GI motility.

Bethanechol is classified as a parasympathomimetic choline ester. Parasympatho-mimetic drugs act by stimulating (or mimicking) the parasympathetic nervous system (PSNS). Bethanochol selectively stimulates muscarinic receptors (with further selectivity for M3 receptors*) without any effect on nicotinic receptors. Unlike acetylcholine, bethanechol is not broken down by cholinesterase and will therefore have a long duration of action.

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