Nasal Oxytocin for Social Deficits in Childhood Autism: A Randomized Controlled Trial

Abstract

The last two decades have witnessed a surge in research investigating the application of oxytocin as a method of enhancing social behaviour in humans. Preliminary evidence suggests oxytocin may have potential as an intervention for autism. We evaluated a 5-day 'live-in' intervention using a double-blind randomized control trial. 38 male youths (7-16 years old) with autism spectrum disorders were administered 24 or 12 international units (depending on weight) intranasal placebo or oxytocin once daily over four consecutive days. The oxytocin or placebo was administered during parent-child interaction training sessions. Parent and child behaviours were assessed using parent reports, clinician ratings, and independent observations, at multiple time points to measure side-effects; social interaction skills; repetitive behaviours; emotion recognition and diagnostic status. Compared to placebo, intranasal oxytocin did not significantly improve emotion recognition, social interaction skills, or general behavioral adjustment in male youths with autism spectrum disorders. The results show that the benefits of nasal oxytocin for young individuals with autism spectrum disorders may be more circumscribed than suggested by previous studies, and suggest caution in recommending it as an intervention that is broadly effective.

Oxytocin enhances brain function in children with autism

“…S3). This is consistent with the empirical record, which shows improvements only on some items from the RMET, according to difficulty level, but not overall (11,22 (1,15) = 2.31, P = 0.15], for all stimuli during their second visit compared with the first (regardless of treatment condition), indicating a practice effect. Fig.…”

“…For example, only modest improvements in social functioning were observed in adults with ASD who were treated daily, for 6 wk, with administration of intranasal OT (14). Similarly, no changes in social behavior were found when OT was given once every morning for 5 d to children with ASD, even in a context of behavioral treatment (15). It may very well be crucial for future utilization in ASD to give OT just before the setting where its impact is being tested and built upon.…”

“…Older participants (aged 16-19 y) received a dose of 24 IU (four puffs per nostril), in accordance with most studies of intranasal OT in adults (22,65). We used age-dependent dosing (as suggested by the scant OT inhalation studies in children (11,15,66), with age as a proxy for size/weight. Twelveto 15-y-olds received 75% of the adult dose (24 IU) or 18 IU (three puffs per nostril).…”

“…Furthermore, although there are several large-scale clinical trials currently underway (www. clinicaltrials.gov) to examine the effects of chronically administered OT in ASD, the empirical record shows that behavioral effects have been mixed at best (13)(14)(15). For example, two recent studies of the effects of repeated daily administration for a period of weeks have resulted in only modest improvements in social behavior (14,15).…”

“…clinicaltrials.gov) to examine the effects of chronically administered OT in ASD, the empirical record shows that behavioral effects have been mixed at best (13)(14)(15). For example, two recent studies of the effects of repeated daily administration for a period of weeks have resulted in only modest improvements in social behavior (14,15). The rapid movement from single administration studies in healthy adults and individuals with ASD to chronic administration to individuals with ASD has introduced a "translational hurdle" (13,16), one that we aimed to tackle by exploring the neural basis of OT's effects.…”