Oxytocin may be useful to increase trust in others and decrease disruptive behaviours in patients with Prader-Willi syndrome: a randomised placebo-controlled trial in 24 patients

Abstract

BackgroundPrader-Willi syndrome (PWS) is a complex neurodevelopmental genetic disorder with hypothalamic dysfunction, early morbid obesity with hyperphagia, and specific psychiatric phenotypes including cognitive and behavioural problems, particularly disruptive behaviours and frequent temper outbursts that preclude socialization. A deficit in oxytocin (OT)-producing neurons of the hypothalamic paraventricular nucleus has been reported in these patients.MethodsIn a double-blind, randomised, placebo-controlled study, 24 adult patients with PWS received a single intranasal administration of 24 IU of OT or placebo and were tested 45 min later on social skills. Behaviours were carefully monitored and scored using an in-house grid as follows: over the two days before drug administration, on the half-day following administration, and over the subsequent two days. All patients were in a dedicated PWS centre with more than ten years of experience. Patients are regularly admitted to this controlled environment.ResultsPatients with PWS who received a single intranasal administration of OT displayed significantly increased trust in others (P = 0.02) and decreased sadness tendencies (P = 0.02) with less disruptive behaviour (P = 0.03) in the two days following administration than did patients who received placebo. In the half-day following administration, we observed a trend towards less conflict with others (p = 0.07) in the OT group compared with the placebo group. Scores in tests assessing social skills were not significantly different between the two groups.ConclusionsThis study needs to be reproduced and adapted. It nevertheless opens new perspectives for patients with PWS and perhaps other syndromes with behavioural disturbances and obesity.Trial registration numberClinicalTrials.gov: NCT01038570

Oxytocin Treatment May Improve Infant Feeding and Social Skills in Prader-Willi Syndrome

“…Subjects who received oxytocin had improved behaviors, including increased trust in others, decreased sadness, and less disruptive behavior shortly after receiving the medication. 7 This study did not, however, discern any difference in social skills between the treated and untreated groups. 7 A more recent double-blind randomized placebo-controlled crossover study of subjects with PWS age 12 to 30 years examined intranasal oxytocin on behavioral outcomes and found little effect.…”

“…In an earlier study by Tauber et al, 7 adults with PWS were treated with intranasal oxytocin or placebo. Subjects who received oxytocin had improved behaviors, including increased trust in others, decreased sadness, and less disruptive behavior shortly after receiving the medication.…”

Oxytocin in survivors of childhood-onset craniopharyngioma

“…After a single intranasal administration of oxytocin, improved patients' trust in others as well as decreased tendencies towards depressed moods could be observed. Not surprisingly, no effects on obesity could be detected from this single oxytocin administration [16]. This study demonstrates that oxytocin therapy might be an option for diseases with hypothalamic dysfunction-induced behavioral disturbances and obesity.…”

“…Indeed, this has been tried in patients with Prader-Willi syndrome (PWS), a genetic disease with hypothalamic dysfunction, severe obesity, and hyperphagia as well as cognitive and behavioral problems. Oxytocin supplementation has been tested in a randomized placebocontrolled trial in 24 PWS patients [16]. After a single intranasal administration of oxytocin, improved patients' trust in others as well as decreased tendencies towards depressed moods could be observed.…”

“…However, in contrast to vasopressin, whose function is well understood and the clinical symptoms in vasopressin-deficient patients are well known [10], little is known about the role of oxytocin in CP patients. Oxytocin is involved in metabolism [11] and in the regulation of a wide variety of social and non-social behaviors such as nonsocial memory, anxiety, depression, and stress [12][13][14][15][16].…”