A randomized trial shows dose-frequency and genotype may determine the therapeutic efficacy of intranasal oxytocin

Psychol Med. 2022 Jul;52(10):1959-1968. doi: 10.1017/S0033291720003803. Epub 2020 Dec 4.

Abstract

Background: The neuropeptide oxytocin is proposed as a promising therapy for social dysfunction by modulating amygdala-mediated social-emotional behavior. Although clinical trials report some benefits of chronic treatment, it is unclear whether efficacy may be influenced by dose frequency or genotype.

Methods: In a randomized, double-blind, placebo-controlled pharmaco-functional magnetic resonance imaging trial (150 male subjects), we investigated acute and different chronic (every day or on alternate days for 5 days) intranasal oxytocin (24 international units) effects and oxytocin receptor genotype-mediated treatment sensitivity on amygdala responses to face emotions. We also investigated similar effects on resting-state functional connectivity between the amygdala and prefrontal cortex.

Results: A single dose of oxytocin-reduced amygdala responses to all face emotions but for threatening (fear and anger) and happy faces, this effect was abolished after daily doses for 5 days but maintained by doses given every other day. The latter dose regime also enhanced associated anxious-arousal attenuation for fear faces. Oxytocin effects on reducing amygdala responses to face emotions only occurred in AA homozygotes of rs53576 and A carriers of rs2254298. The effects of oxytocin on resting-state functional connectivity were not influenced by either dose-frequency or receptor genotype.

Conclusions: Infrequent chronic oxytocin administration may be therapeutically most efficient and its anxiolytic neural and behavioral actions are highly genotype-dependent in males.

Keywords: Amygdala; dose-frequency; fearful faces; oxytocin; oxytocin receptor gene; resting-state.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Intranasal
  • Amygdala* / diagnostic imaging
  • Amygdala* / physiology
  • Double-Blind Method
  • Emotions / physiology
  • Genotype
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Oxytocin* / pharmacology

Substances

  • Oxytocin