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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