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Sniffing around oxytocin: review and meta-analyses of trials in healthy and clinical groups with implications for pharmacotherapy
Open accessAbstract
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.
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“These studies yielded summarized effect sizes ranging from d=0.21 to d=0.48.”
From Statistical and Methodological Considerations for the Interpretation of Intranasal Oxytocin Studies (2016) · cites this paper as [11]
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“The meta-analyses mentioned in this paper all tested for evidence of publication bias in the IN-OT literature, with mixed results (9–11).”
From Statistical and Methodological Considerations for the Interpretation of Intranasal Oxytocin Studies (2016) · cites this paper as [11]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Finally, in the meta-analysis by Bakermans-Kranenburg and Van IJzendoorn (11) IN-OT seems to have the largest effect size in individuals with autism. Only four studies of autism were included in the analysis and should therefore be interpreted cautiously. However, the larger effect size for autism (d=0.57) compared to all clinical studies (d=0.32)”
From Statistical and Methodological Considerations for the Interpretation of Intranasal Oxytocin Studies (2016) · cites this paper as [11]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
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“Bakermans-Kranenburg and Van IJzendoorn studied the effect of IN-OT in clinical trials (19 effect sizes, total N=304)(11).”
From Statistical and Methodological Considerations for the Interpretation of Intranasal Oxytocin Studies (2016) · cites this paper as [11]
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“To date three meta-analyses of the effects of IN-OT on human behavior have been published.”
From Statistical and Methodological Considerations for the Interpretation of Intranasal Oxytocin Studies (2016) · cites this paper as [11]
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“Only four studies of autism were included in the analysis and should therefore be interpreted cautiously.”
From Statistical and Methodological Considerations for the Interpretation of Intranasal Oxytocin Studies (2016) · cites this paper as [11]
In the citing paper
“Several clinical studies have also investigated the potential of intranasal oxytocin as a treatment for socio-cognitive, behavioral, and socio-affective symptoms of ASD. So far, these studies cannot provide a certain conclusion about oxytocin’s therapeutic potential43–47.”
From Randomized clinical trial shows no substantial modulation of empathy-related neural activation by intranasal oxytocin in autism (2021) · cites this paper as [46]
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“In typically developing individuals, OT has been linked to interpersonal bonding, parental care, and the ability to establish trust and form social attachments [2, 3].”
From Behavioral effects of multiple-dose oxytocin treatment in autism: a randomized, placebo-controlled trial with long-term follow-up (2020) · cites this paper as [2]
In the citing paper
“the genetic background of oxytocin system might influence efficacy of oxytocin administration.19, 20”
From Oxytocin efficacy is modulated by dosage and oxytocin receptor genotype in young adults with high-functioning autism: a 24-week randomized clinical trial (2016) · cites this paper as [19]
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“oxytocin is emerging as a pharmacological target for social dysfunction in clinical trials (29, 30).”
From Placebo treatment facilitates social trust and approach behavior (2018) · cites this paper as [30]
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Evenepoel, M., Moerkerke, M., Daniëls, N., Chubar, V., Claes, S. J., Turner, J. D., Vanaudenaerde, B. M., Willems, L., Verhaeghe, J., Prinsen, J., et al. (2023) · Translational Psychiatry · doi:10.1038/s41398-023-02524-0 · Cited by 27
Weinstein, T. A. R., Bales, K. L., Maninger, N., Hostetler, C. M., & Capitanio, J. P. (2014) · Frontiers in Behavioral Neuroscience · doi:10.3389/fnbeh.2014.00295 · Cited by 27
Althaus, M., Groen, Y., Wijers, A. A., Noltes, H., Tucha, O. M., Sweep, F. C. G. J., Calcagnoli, F., & Hoekstra, P. J. (2016) · Psychopharmacology · doi:10.1007/s00213-016-4339-1 · Cited by 28
Voorthuis, A., Riem, M. M. E., van IJzendoorn, M. H., & Bakermans‐Kranenburg, M. J. (2013) · Brain Research · doi:10.1016/j.brainres.2013.10.051 · Cited by 28
“We found however no difference in basal oxytocin levels, no associations between basal oxytocin and emotion recognition, and in a meta-analysis differences in OXTR rs53576 and rs2254298 were not related to social-emotional behavior (Bakermans-Kranenburg and Van IJzendoorn, 2013).”
BackgroundResultOxytocin Normalizes Approach–Avoidance Behavior in Women With Borderline Personality Disorder
Schneider, I., Boll, S., Volman, I., Roelofs, K., Spohn, A., Herpertz, S. C., & Bertsch, K. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.00120 · Cited by 28
“The AAT was conducted ∼75min after substance application, which is still in the range of elevated peripheral and presumably also central oxytocin levels (40, 41) but might be past its peak levels (30–60min after application) in the cerebral spinal fluid (42).”
BackgroundPopow, C., Ohmann, S., & Plener, P. L. (2021) · Neuropsychiatrie · doi:10.1007/s40211-021-00395-9 · Cited by 37
Kovács, B., & Kéri, S. (2015) · European Psychiatry · doi:10.1016/j.eurpsy.2015.02.010 · Cited by 26
“The authors of these papers emphasized the limited understating of mechanism of action, lack of information on dose-response relationship, long-term safety, social contextual effects, ethical issues regarding behavioral modulation, and the controversial impact of oxytocin in real-life circumstances [2,5,13,20,29,52,54…”
BackgroundBos, P. A., Montoya, E. R., Terburg, D., & van Honk, J. (2014) · Human Brain Mapping · doi:10.1002/hbm.22537 · Cited by 26
Recent findings on the pathophysiology of social anxiety disorder
Marazziti, D., Abelli, M., Baroni, S., Carpita, B., Piccinni, A., & Dell’Osso, L. (2014) · Cited by 26
Oxytocin Reduces Cigarette Consumption in Daily Smokers
Hedger, K. V., Kushner, M. J., Lee, R., & de Wit, H. (2018) · Nicotine & Tobacco Research · doi:10.1093/ntr/nty080 · Cited by 26
Moy, S. S., Teng, B. L., Nikolova, V. D., Riddick, N. V., Simpson, C. D., Deusen, A. L. V., Janzen, W. P., Sassano, M. F., Pedersen, C. A., & Jarstfer, M. B. (2018) · Neuropharmacology · doi:10.1016/j.neuropharm.2018.10.036 · Cited by 26
Neuroendocrine Regulation of Anxiety: Beyond the Hypothalamic‐Pituitary‐Adrenal Axis
Borrow, A. P., Stranahan, A. M., Suchecki, D., & Yunes, R. (2016) · Journal of Neuroendocrinology · doi:10.1111/jne.12403 · Cited by 27
Riem, M. M. E., Carli, P. D., van IJzendoorn, M. H., Linting, M., Grewen, K., & Bakermans‐Kranenburg, M. J. (2017) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2017.08.017 · Cited by 29
Riem, M. M. E., Kunst, L. E., Steenbakkers, F. D. F., Kir, M., Sluijtman, A., Karreman, A., & Bekker, M. H. J. (2019) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2019.06.012 · Cited by 25
Kujath, A. S., Quinn, L. T., Elliott, M. E., Varady, K. A., LeCaire, T. J., Carter, C. S., & Danielson, K. K. (2014) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.2577 · Cited by 24
“Oxytocin has been widely studied in the context of social behaviours, including oxytocin’s inverse association with stress and depression [22].”
BackgroundTobón, A. L., Newport, D. J., & Nemeroff, C. B. (2018) · Current Treatment Options in Psychiatry · doi:10.1007/s40501-018-0158-9 · Cited by 26
Childhood Maltreatment Alters the Neural Processing of Chemosensory Stress Signals
Maier, A., Heinen-Ludwig, L., Güntürkün, O., Hurlemann, R., & Scheele, D. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.00783 · Cited by 27
“However, previous studies also reported diminished stress-attenuating (92) or prosocial (93) effects of OXT in individuals who have experienced CM.”
ResultMorais, L. H., Golubeva, A. V., Casey, S., Scott, K. A., Costa, A. P., Moloney, G. M., Dinan, T. G., & Cryan, J. F. (2021) · Neuropsychopharmacology · doi:10.1038/s41386-021-01040-3 · Cited by 24
Moerkerke, M., Daniëls, N., der Donck, S. V., Tibermont, L., Tang, T., Debbaut, E., Bamps, A., Prinsen, J., Steyaert, J. G., Alaerts, K., et al. (2023) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.13850 · Cited by 23
Olofsdotter, S., Åslund, C., Furmark, T., Comasco, E., & Nilsson, K. W. (2017) · Development and Psychopathology · doi:10.1017/s0954579417000967 · Cited by 26
Effects of Three Lipidated Oxytocin Analogs on Behavioral Deficits in CD38 Knockout Mice
Михайлович, Ч. С., Akther, S., Nishimura, T., Shabalova, A. A., Mizuno, A., Ichinose, W., Shuto, S., Yamamoto, Y., Yokoyama, S., & Higashida, H. (2017) · Brain Sciences · doi:10.3390/brainsci7100132 · Cited by 23
“A single or repetitive intranasal administration of OT in randomized controlled trials has been demonstrated to elicit the recovery of some parameters of social behavior in ASD patients [25,26], while other trials failed to show positive effects [27–29].”
ResultStrauss, G. P., Granholm, E. L., Holden, J. L., Ruiz, I., Gold, J. M., Kelly, D. L., & Buchanan, R. W. (2018) · Psychological Medicine · doi:10.1017/s0033291718002465 · Cited by 25
“…tasks (e.g. dosing, pharmacodynamics, whether oxytocin reaches intended neural structures, and receptor distribution) (Guastella and MacLeod, 2012; Bakermans-Kranenburg and Van Ijzendoorn, 2013; Freeman and Young, 2016; Leng and Ludwig, 2016; Quintana and Woolley, 2016; Quintana et al., 2018).”
BackgroundMayer, A. V., Wermter, A.-K., Stroth, S., Alter, P., Haberhausen, M., Stehr, T., Paulus, F. M., Krach, S., & Kamp-Becker, I. (2021) · Scientific Reports · doi:10.1038/s41598-021-94407-x · Cited by 23
Hosseini, S. M. R., Farokhnia, M., Rezaei, F., Gougol, A., Yekehtaz, H., Iranpour, N., Salehi, B., Tabrizi, M. H., Tajdini, M., Ghaleiha, A., et al. (2014) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2014.02.001 · Cited by 23
Borderline Personality Disorder and Oxytocin: Review of Clinical Trials and Future Directions
Amad, A., Thomas, P., & Pérez-Rodríguez, M. M. (2015) · Current Pharmaceutical Design · doi:10.2174/1381612821666150619093019 · Cited by 22
Oxytocin treatment in pediatric populations
Taylor, A. E., Lee, H.-E., & Buisman‐Pijlman, F. T. A. (2014) · Frontiers in Behavioral Neuroscience · doi:10.3389/fnbeh.2014.00360 · Cited by 23
“In the context of developmental trauma, positive effects (behaviorally or neurobiologically) were in fact lowered or absent (Bakermans-Kranenburg and Van IJzendoorn, 2013).”
BackgroundBhandari, R., van der Veen, R., Parsons, C. E., Young, K. S., Voorthuis, A., Bakermans‐Kranenburg, M. J., Stein, A. L., Kringelbach, M. L., & van IJzendoorn, M. H. (2014) · Social Neuroscience · doi:10.1080/17470919.2014.932307 · Cited by 23
Transcutaneous Vagus Nerve Stimulation (tVNS) does not increase prosocial behavior in Cyberball
Sellaro, R., Steenbergen, L., Verkuil, B., van IJzendoorn, M. H., & Colzato, L. S. (2015) · Frontiers in Psychology · doi:10.3389/fpsyg.2015.00499 · Cited by 26
L’ocytocine et la dépression du post-partum
Cardaillac, C., Rua, C., Simon, E. G., & El‐Hage, W. (2016) · Journal de gynécologie, obstétrique et biologie de la reproduction. Supplément/Journal de gynécologie obstétrique et biologie de la reproduction · doi:10.1016/j.jgyn.2016.05.002 · Cited by 23
Oxytocin improves the ability of dogs to follow informative pointing: a neuroemotional hypothesis
Macchitella, L., Stegagno, T., Giaconella, R., di Sorrentino, E. P., Schino, G., & Addessi, E. (2016) · RENDICONTI LINCEI · doi:10.1007/s12210-016-0579-6 · Cited by 22
Fragkaki, I., Cima, M., Verhagen, M., Maciejewski, D. F., Boks, M. P., van Lier, P. A. C., Koot, H. M., Branje, S., & Meeus, W. (2018) · Journal of Youth and Adolescence · doi:10.1007/s10964-018-0939-x · Cited by 24
Metadata
- Authors
- Bakermans-Kranenburg, M. J., & van IJzendoorn, M. H.
- Venue
- Translational Psychiatry
- Published
- 2013-05-21
- Volume
- 3
- Issue
- 5
- Pages
- e258-e258
- ISSN
- 2158-3188 (ISSN-L)
- PMC
- PMC3669921
- OpenAlex
- W1966317054
- Cited by
- 383
- References
- 142
- Citations by year
- 2026: 7 · 2025: 13 · 2024: 12 · 2023: 18 · 2022: 11 · 2021: 24 · 2020: 22 · 2019: 29 · 2018: 41 · 2017: 55 · 2016: 43 · 2015: 59 · 2014: 40 · 2013: 9
- FWCI
- 6.67
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc-nd
- www.springer.com/tdm (unspecified)
- Locations
- Translational Psychiatry (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- Nederlandse Organisatie voor Wetenschappelijk Onderzoek
- Topics
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Neuroendocrine regulation and behavior
- Life Sciences › Neuroscience › Sensory Systems › Olfactory and Sensory Function Studies
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Keywords
- oxytocin, intranasal administration, pharmacotherapy, autism spectrum disorder, social anxiety, postpartum depression, obsessive-compulsive disorder, schizophrenia, borderline personality disorder, post-traumatic stress disorder, emotion recognition, trust, child abuse, personality moderators, treatment effect size
- MeSH terms
- Administration, Intranasal, Anxiety, Mental Disorders, Child, Child Development Disorders, Pervasive, Depression, Humans, Oxytocin, Personality Disorders, Phobic Disorders, Schizophrenia, Stress Disorders, Post-Traumatic, Anti-Anxiety Agents, Trust
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