Oxytocin in Schizophrenia and Autism

Oxytocin is not the social panacea, it’s not a universal prosocial enhancer that can render all people social-cognitive experts. In my previous post Oxytocin was only of benefit to less socially proficient individuals not in more socially proficient individuals. So can it be useful for patients with schizophrenia or autism. Patients with schizophrenia with negative symptoms often have inappropriate social skills or lack of interest or ability to socialize with other people. It’s often hard for them to make friends or keep friends, or they’re not caring to have friends. Patients with autism spectrum disorders often fail to pick up on social cues.

Higher levels of oxytocin is associated with less severe positive and negative symptoms in schizophrenia. In a randomized placebo controlled crossover trial of oxytocin as an adjunct to antipsychotic medications in 19 patients with schizophrenia, oxytocin reduced symptoms after 3 weeks. These are preliminary findings and request replication. Moreover, it is still unsure whether oxytocin mostly used intra-nasally is safe. Large-scale safety and efficacy studies are needed for specific indications. Results are positive but not impressive, the effect on negative symptoms doesn’t stick out from the results as hoped for.

Comparing intranasal oxytocin with placebo in 13 adult patients with Asperger syndrome or high functioning autism and 13 matched healthy controls showed some improvement in social interaction when playing games in the patient group.

Another randomized, blinded controlled trial of 16 male patients aged 12 to 19 years with an autism spectrum disorder found that intranasal oxytocin improved patients’ performance on the Reading the Mind in the Eyes Task, a test of patients’ ability to recognize emotion in people’s faces (Guastella AJ et al. Biol Psychiatry. 010;67[7]:692-694).

From a systematic review beneficial effects of oxytocin on irritability and repetitive behavior were found in autism spectrum disorder. Oxytocin seems to work on some symptoms of autism but certainly not all symptoms, researchers interviewed in this news item in the JAMA suggest that efficiacy of oxytocin might improve when combined by other therapies such as socially reinforced behavioral therapies. It’s also not clear whether administration of oxytocin or increasing endogenous oxytocin is of more benefit. They all warn against to much optimism about the effects of oxytocin and the dangers of the use of oxytocin by individuals without physician supervision.

Some web sites claim to market oxytocin for use in boosting trust in relationships. “It’s important for [individuals] to realize it’s not the time for them to start taking these drugs without a physician,” he said. “We don’t know the safety issues.”

Kuehn BM (2011). Scientists probe oxytocin therapy for social deficits in autism, schizophrenia. JAMA : the journal of the American Medical Association, 305 (7), 659-61 PMID: 21325177