A Preliminary Examination of Endogenous Peripheral Oxytocin in a Pilot Randomized Clinical Trial of Oxytocin-Enhanced Psychotherapy for Posttraumatic Stress Disorder

Abstract

Background Preclinical and clinical research suggests that the oxytocin system is implicated in the development and maintenance of stress and anxiety-related psychiatric conditions, such as posttraumatic stress disorder (PTSD). Recent research also suggests that intranasal oxytocin holds promise as a treatment for PTSD. However, little is known about the relationship between levels of peripheral oxytocin and PTSD symptom severity, PTSD treatment response, and repeated intranasal oxytocin administration. Methods In the current study, we examined associations between PTSD symptom severity and peripheral oxytocin levels measured in plasma before and after a course of prolonged exposure (PE) for PTSD (n = 13); participants were randomized to adjunctive intranasal oxytocin (n = 6) or placebo (n = 7). Results Baseline peripheral oxytocin levels were not associated with baseline PTSD symptom severity. Change in peripheral oxytocin levels did not differ by treatment condition and did not correspond to change in PTSD symptoms. Conclusions This proof-of-concept study illustrates the acceptability and feasibility of measuring peripheral oxytocin among individuals engaged in psychotherapy for PTSD and informs the utilization of these procedures in future adequately powered studies.

Associations between oxytocin and vasopressin concentrations, traumatic event exposure and posttraumatic stress disorder symptoms: group comparisons, correlations, and courses during an internet-based cognitive-behavioural treatment

“…In the trial that evaluated repeated intranasal oxytocin administration as PTSD prevention (van Zuiden et al, 2017 ), blood oxytocin concentrations were neither prognostic biomarkers for PTSD symptom development, nor prescriptive biomarkers of the intervention’s effectiveness (Engel et al, 2020 ). Likewise, in the clinical trial that investigated the role of blood oxytocin concentrations in a prolonged exposure intervention that was augmented by intranasal oxytocin administration (Flanagan et al, 2018 ), these concentrations were not correlated with PTSD symptoms before intervention onset, nor did they correspond with symptom changes (Sippel et al, 2020 ).…”

“…Another clinical trial evaluated the effects of intranasal oxytocin as potential TF-CBT enhancer (Flanagan, Sippel, Wahlquist, Moran-Santa Maria, & Back, 2018 ). A follow-up investigation of this trial also investigated the role of blood oxytocin concentrations with regard to this intervention (Sippel, King, Wahlquist, & Flanagan, 2020 ). The present study is the first one that included measurements of both, oxytocin and vasopressin into the clinical evaluation of TF-CBT.…”

Social withdrawal and gender differences: Clinical phenotypes and biological bases

“…The high complexity of social functioning can explain the elevated vulnerability to different internal and external pathogenic influences, which can result in a wide range of psychiatric disorders associated with social withdrawal, such as anxiety disorders (Plana et al, 2014), post‐traumatic stress disorder (PTSD) (Sipper et al, 2020), major depressive disorder (Bora & Berk, 2016; Kupferberg et al, 2016), autism spectrum disorders (ASDs) (Barlati et al, 2020), and schizophrenia (Rocca et al, 2016). Social withdrawal can be the first sign of these disorders, sometimes years before the full‐blown symptomatology and diagnosis, and independent from other symptoms, and is associated with negative prognostic implications, in terms of poorer outcome and more frequent treatment refractoriness.…”

“…It is noteworthy that both VP and OT have been implicated in different psychiatric disorders presenting with social dysfunctions and withdrawal (see for a review Rutigliano et al, 2016), such as schizophrenia (Jobst et al, 2014), ASD (LoParo & Waldman, 2015; Xu et al, 2013; Yang et al, 2010), depression (Jobst et al, 2015; Yueng et al, 2014), anxiety disorders (Yoon & Kim, 2020), and PTSD (Sipper et al, 2020). Knowledge on how OT and VP may mediate gender‐specific social behavior may provide useful insight into gender‐specific treatment strategies in these psychiatric disorders.…”