Autism and Obsessive Compulsive Spectrum Program

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A Hormone May Treat Autism, Social Disorders 


October 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 interaction.

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 Psychoneuroendocrinology.

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    

Dr. 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)

“In 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 (March 2005)

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