Abstract
The popularity of oxytocin (OT) has grown exponentially during the past decade, and so has the number of OT trials in healthy and clinical groups. We take stock of the evidence from these studies to explore potentials and limitations of pharmacotherapeutic applications. In healthy participants, intranasally administered OT leads to better emotion recognition and more trust in conspecifics, but the effects appear to be moderated by context (perceived threat of the ‘out-group'), personality and childhood experiences. In individuals with untoward childhood experiences, positive behavioral or neurobiological effects seem lowered or absent. In 19 clinical trials, covering autism, social anxiety, postnatal depression, obsessive-compulsive problems, schizophrenia, borderline personality disorder and post-traumatic stress, the effects of OT administration were tested, with doses ranging from 15 IU to more than 7000 IU. The combined effect size was d=0.32 (N=304; 95% confidence interval (CI): 0.18–0.47; P<0.01). However, of all disorders, only studies on autism spectrum disorder showed a significant combined effect size (d=0.57; N=68; 95% CI: 0.15–0.99; P<0.01). We hypothesize that for some of the other disorders, etiological factors rooted in negative childhood experiences may also have a role in the diminished effectiveness of treatment with OT.
Highlights
On the internet oxytocin (OT) is the most popular nonapeptide, with more than 5.7 million hits by the end of 2012, and its popularity has been growing exponentially during the past 10 years
We examined the hypothesis that OT promotes parochial altruism, suggesting that trust in outgroup members may decrease after OT administration
It may be concluded that OT administration does not generate positive effects in individuals who as a consequence of unfavorable early caregiving experiences may have a bias towards negative interpretation of social cues
Summary
On the internet oxytocin (OT) is the most popular nonapeptide, with more than 5.7 million hits by the end of 2012, and its popularity has been growing exponentially during the past 10 years. OT: its use in pharmacotherapy MJ Bakermans-Kranenburg and MH van IJzendoorn suggests an important role of OT in human caregiving.[11] Higher maternal OT levels across pregnancy predict higher quality of postpartum maternal behavior.[12] In pregnant women, lower plasma OT levels in mid-gestation are predictive of postnatal depression.[13] More generally, depressive symptomatology has been found related to lower plasma OT levels,[14,15] not consistently so.[16] in patients with schizophrenia, plasma OT levels were found to be lower than in non-clinical subjects, and they correlated negatively with psychotic symptoms.[17,18] Patients with Prader–Willi syndrome were reported to have a deficit in the OT-producing neurons of the paraventricular nuclei.[19] The idea to use OT administration in the treatment of these clinical groups is not far-fetched. Basic research on the neurobiological pathway of intranasal OT to pertinent parts of the brain is badly needed
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