Abstract
In a short time, oxytocin has progressed from being a regular hormone involved in parturition and breastfeeding to be possibly the neuromodulator that has gathered the most attention. Attributed many positive roles in the modulation of different aspects of social behavior, such as bonding, empathy, cooperation, trust, and generosity, as well as roles as a natural anxiolytic and antidepressant, the expectations on oxytocin becoming a treatment for a number of disorders with associated social deficits have dramatically raised over the last years. However, despite the field has been investigating oxytocin’s role in social behavior for over twenty years, there are still many unknowns on oxytocin’s mechanisms of action and efficiency and the increasing number of clinical trials administering oxytocin to different clinical groups seem to disagree in its properties and report in most cases conflicting results. This has led to some disappointment among researchers and clinicians as oxytocin might not be the miraculous molecule that works in a “one size fits all” fashion initially considered. Conversely, this down-side of oxytocin might merely reflect the complexity of its neurotransmission system. The current reality is that, although oxytocin seems to have potential therapeutic value, there are key questions that remain unanswered as to decide the optimal target groups and treatment course. Here, we present an overview on critical points regarding the oxytocin system in health and disease that need to be better understood to establish its therapeutic properties and to decide who could benefit the most from its treatment.
Highlights
The field of clinical behavioral neuroscience has rarely experienced such an enthusiasm for a single molecule as the one elicited by oxytocin (OXT)
In the recent years, there has been an explosion in the number of clinical trials to test OXT’s efficiency in improving social deficits in a variety of conditions with associated social
Another study that included 15 reports on a different clinical population, found that OXT did not significantly influence any of the same behavioral outcomes [37]. These differences might be due to the specific clinical populations included in each work, as another study covering 19 clinical trials including individuals with autism, social anxiety, postnatal depression, obsessive-compulsive disorder, schizophrenia, borderline personality disorder, and post-traumatic stress, showed that only the autism group presented a significant effect on social parameters [38], indicating that studies focused on a specific diagnosis, with a common behavioral domain affected, could be helpful
Summary
The field of clinical behavioral neuroscience has rarely experienced such an enthusiasm for a single molecule as the one elicited by oxytocin (OXT). The potential success of OXT as a pharmacotherapy is exciting, the increasing number of treatment studies report conflicting results and several issues need to be addressed before accepting the effectiveness of this molecule. Important questions such as selection of the clinical sample, dosage, timing, effect by sex, behavioral outcome measure, neurobiological effect or correlation with OXT-related biomarkers, to potentially identify best responders, have not been systematically addressed. First we summarize important aspects of the OXT signaling system which should be considered to inform treatments; later, we present evidence linking alterations in the OXT system in neuropsychiatric disorders characterized by social dysfunction and last, we summarize results of OXT treatments in clinical trials together with an overview on critical points that need to be better understood to establish its therapeutic properties and to decide who could benefit the most from its treatment
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