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Table 1 Activities that seemed to affect D-MER, with their presumed effects on dopamine and oxytocin

From: Dysphoric milk ejection reflex: A case report

Activity Dopamine Oxytocin Observed effect on D-MER symptoms Comments
Alcohol - one serving 0 0[24] none  
Smoking - two to five cigarettes in rapid succession ↓ [25] improved Numerous studies show an increase in dopamine with exposure to nicotine.
Pseudo-ephedrine (two 30 mg tablets) ↑ [10] 0? improved PSE may reduce milk supply by reducing prolactin, implying an increase in dopamine. No literature found on the effect of pseudoephedrine on oxytocin release.
Bupropion - 150 mg/day ↑ [21] 0? improved No literature found on the effect of bupropion on oxytocin release.
Chocolate ice cream binge ↑ [1, 26] improved Occasional evening binges were followed by a small window of D-MER-free breastfeeding.
Chronic moderate stress improved  
Caffeine ↑and↓ 0 worsened Some internet hints of a dopamine rise and subsequent "crash" were not verified
Acute stress ↓ [27] ↑ [28] worsened  
Metoclopramide ↓ [29] 0 worsened Administered by IV during pregnancy; reaction was similar to D-MER
Immediately after meals with extended family ? 0 worsened Relations with extended family were good. While the worsening of symptoms was noticeable at family gatherings, we have no explanation.
  1. Note: 0 = neurotransmitter release unaffected by activity/drug listed; ↑ = neurotransmitter release increased by that activity/drug; ↓ = neurotransmitter release decreased; ? = uncertainty about effect of activity/drug on neurotransmitter