A Hormone May Treat Autism, Social Disorders
1, 2011, The Wall Street Journal
Researchers are finding that a hormone in the body believed to
help people form emotional bonds with each other may work to treat people with
schizophrenia, autism and certain other psychiatric disorders related to social
A number of small scientific studies have been published recently
suggesting that puffs of oxytocin into the nose may reduce some symptoms in
people with these disorders and improve their ability to function. In
particular, the hormone seemed to enhance patients' abilities to recognize
others' emotions, which is a crucial step in improving social interactions.
Oxytocin, produced both by men and women, is nicknamed the
"love hormone" because of its apparent role in building trust between
people. Women, for instance produce large amounts of oxytocin during labor
preceding childbirth, presumably to foster bonding with the newborn.
The hormone works by helping neurons in the brain talk to each
other, although the exact mechanism isn't understood. Researchers
suggest it may increase a person's attention to social information
in the environment, make social interactions more rewarding or reduce anxiety
in those situations. When sprayed in the nose, oxytocin is thought to travel
along a pathway to reach the brain.
Other natural substances have been deployed for medical use, such
as dopamine for Parkinson's disease or mood disorders. But as a potential
treatment for mental disorders, oxytocin represents "a whole new class of
pharmaceuticals—pro-social compounds," said Thomas Insel, director of the
National Institute of Mental Health, who conducted some of the earliest work on
oxytocin in animals.
People with schizophrenia tend not to show much emotion, hold
paranoid thoughts and speak little, according to the National Institute of
Mental Health. Antipsychotic medications help control paranoid or unrealistic
thoughts but don't address many other symptoms, said Dr. Insel. Similarly,
people with autism and related disorders have difficulty forming relationships,
and existing treatments that teach social skills and reward positive social
interactions have limited benefit for some patients. There aren't any drugs
that address the core symptoms of the condition, he said.
A 21-patient study published in August in the journal
Psychological Medicine found that when people with schizophrenia were given
oxytocin in the nose, their ability to accurately identify a face as happy,
surprised, fearful or sad improved significantly. The effect was subtle but
immediate; the improvement was seen just 50 minutes after administration of the
oxytocin, said Bruno Averbeck, unit chief of neuropsychology at the National
Institute of Mental Health, who conducted the research along with scientists at
King's College London. Dr. Averbeck said the researchers are now working to
improve the potency of the effect by figuring out which neural circuits are
involved and how oxytocin affects them.
In another study, David Feifel, a psychiatry professor at
University of California, San Diego, and his team found that giving one
intranasal dose of oxytocin every day for three weeks to people with
schizophrenia decreased some symptoms, such as paranoia and suspiciousness, and
improved patients' overall ability to function, even though the patients were
already taking antipsychotic medications. There wasn't any effect in a group of
patients given placebo saline sprays. The study, involving 19 patients, was
published last year in Biological Psychiatry.
Oxytocin has been on researchers' radar since the 1970s when
animal studies demonstrated that it was linked to maternal and other
social-bonding behaviors. The more oxytocin in the animals' systems, the more
they exhibited affiliation behaviors. In 2005, a study looked at people without
any psychiatric conditions and found that administering the hormone increased
trust and cooperation. That study, published in Nature, spurred excitement in the
field about oxytocin's possible use in treating illness.
A series of studies at Montefiore Medical Center and the Albert
Einstein School of Medicine in the Bronx, N.Y., gave oxytocin to people with
autism and related disorders. Both intravenous and intranasal administration of
the hormone appeared to reduce repetitive behaviors, which is characteristic of
people with autism, said Eric Hollander, director of the autism and
obsessive-compulsive spectrum program. Oxytocin also reduced the patients' irritability
and increased their overall ability to function, he said.
In one of Dr. Hollander's studies, 15 patients with
high-functioning autism listened to sentences read in four different emotional
tones. Participants, half of whom were infused with oxytocin and the other half
with a placebo, had to identify the emotion. The first group, given oxytocin,
was significantly more successful at the task than were people who received a
placebo. There weren't any reported significant side effects.
Patients returned two weeks later to repeat the exercise. If they
were given oxytocin the first test period, they were given placebo during the
second visit, and vice versa. Surprisingly, researchers said, the people who
received oxytocin in the first session maintained their ability to recognize
emotions two weeks later when they returned for the second session.
"Those individuals who had gotten oxytocin were able to lay
down new social memories," Dr. Hollander said.
In general, however, the effects of oxytocin in studies don't
appear to last long after the hormone is administered and it would likely need
to be used continually for there to be a therapeutic effect, researchers said.
(In the body, the hormone sticks around for just a few minutes after it is
produced.) Researchers said there have been preliminary discussions with some
pharmaceutical companies about manufacturing more potent versions of oxytocin
that perhaps could be taken orally for treating psychiatric conditions.
Scientists have hopes that oxytocin can also be beneficial for
other disorders, such as social anxiety, though little work has been completed.
Adam Guastella, a professor at University of Sydney's Brain and Mind Research
Institute in Australia, said a randomized controlled study of 25 people with social
anxiety found that oxytocin resulted in the patients having a more positive
image of themselves, but overall symptoms of the disorder weren't reduced. The
study was published in 2009 in Psychoneuroendocrinology.
The hormone could have some drawbacks, including the potential to
exacerbate certain negative feelings. Dr. Hollander said that in a small study
of patients with borderline personality disorder, in which people are extremely
sensitive to social rejection, oxytocin appeared to make their condition worse.
He suggested the hormone might have increased the patients' attentiveness to
social information. The study was published this year in
A synthetic form of oxytocin, often known by the brand name
Pitocin, is used to induce labor in women. The hormone is approved for use in
its intravenous form in the U.S. and is generally considered safe to use. It
doesn't seem to produce a "high" or affect mood, which makes it
unlikely to be abused, experts said.
Some companies market sprays online that they say contain oxytocin
with the claim that spritzing one's clothing with the hormone
before a business meeting, for instance, will make other people
more trusting and cooperative. This is doubtful, scientists said, since
oxytocin used externally isn't likely to reach the brain's neural receptors.
More News and Events
Hollander will present his work on The Neuropsychopharmacolgy of Oxytocin and
Inflammation in Autism Spectrum Disorders at the 2012 ICare4Autism International Autism Conference (August 1-2, 2012)
Our team is participating in Walk Now for Autism on June 3rd (2012). You can register for
our team and walk with us or donate to the Walk Now cause. An excerpt about the
walk: “Autism Speaks is proud of our signature fundraising event which brings
together hundreds of thousands of participants annually across the United
States and Canada with a common goal of supporting Autism Speaks. Powered by
volunteers and families with loved ones on the autism spectrum, this successful
grassroots fundraising effort not only generates vital funds for autism
research but also raises awareness about the increasing prevalence of autism
and the need for increased research funding to combat this complex disorder.”
Dr. Hollander writes for Psychiatry Online and talks about future direction for
Autism research. (April 6, 2012).
Dr. Hollander’s upcoming TSO Trial is mentioned in the Wall Street Journal. In addition to its usefulness treating Crohn’s Disease and Multiple Sclerosis, TSO may be a powerful tool in addressing the symptoms of autism. (February 14, 2012).
TIME discusses Dr. Hollander’s recent study
on Prozac use and symptoms of Autism. Excerpt from the article: “When taking
Prozac, Hollander says, “Patients acknowledge experiencing less discomfort.
They’re more able to go outside their comfort zone and to better resist their
habits and rituals.” One participant in Hollander’s study was previously too
anxious to take the subway or eat in a restaurant, but, when taking Prozac, was
able to tolerate these unpredictable environments.” (December 5, 2011)
Dr. Hollander explains the role of oxytocin in
Autism in an interview with The Daily Beast. Oxytocin may be important, says Dr. Hollander,
in improving social cognition and reducing repetitive, self-stimulating
behaviors (February 25, 2010)
Dr. Hollander has an expert interview with Medscape Education about the characteristics and treatment
of Autism (May 2005)
Session with Eric Hollander, MD,” an interview on Obsessive-Compulsive Spectrum
Disorders, is published in Primary Psychiatry. Dr. Hollander discusses the qualities,
classification and misconceptions of Obsessive-Compulsive Spectrum Disorders