Guastella Adam J, Gray Kylie M, Rinehart Nicole J, Alvares Gail A, Tonge Bruce J, Hickie Ian B, Keating Caroline M, Cacciotti-Saija Cristina, Einfeld Stewart L
Autism Clinic for Translational Research, Brain & Mind Research Institute, University of Sydney, Sydney, NSW, Australia.
J Child Psychol Psychiatry. 2015 Apr;56(4):444-52. doi: 10.1111/jcpp.12305. Epub 2014 Aug 2.
There is increasing interest in oxytocin as a therapeutic to treat social deficits in autism spectrum disorders (ASD). The aim of this study was to investigate the efficacy of a course of oxytocin nasal spray to improve social behavior in youth with ASD.
In a double-blind, placebo-controlled trial across two Australian university sites between February 2009 and January 2012, 50 male participants aged between 12 and 18 years, with Autistic or Asperger's Disorder, were randomized to receive either oxytocin (n = 26) or placebo (n = 24) nasal sprays (either 18 or 24 International Units), administered twice-daily for 8 weeks. Participants were assessed at baseline, after 4- and 8-weeks of treatment, and at 3-month follow-up. Primary outcomes were change in total scores on the caregiver-completed Social Responsiveness Scale and clinician-ratings on the Clinical Global Impressions-Improvement scale. Secondary assessments included caregiver reports of repetitive and other developmental behaviors and social cognition.
Australian New Zealand Clinical Trials Registry www.anzctr.org.au ACTRN12609000513213.
Participants who received oxytocin showed no benefit following treatment on primary or secondary outcomes. However, caregivers who believed their children received oxytocin reported greater improvements compared to caregivers who believed their child received placebo. Nasal sprays were well tolerated and there was no evidence of increased side effects resulting from oxytocin administration.
This is the first evaluation of the efficacy for a course of oxytocin treatment for youth with ASD. Although results did not suggest clinical efficacy, further research is needed to explore alternative delivery methods, earlier age of intervention, and the influence of caregiver expectation on treatment response.
催产素作为治疗自闭症谱系障碍(ASD)社交缺陷的一种疗法,正受到越来越多的关注。本研究的目的是调查一个疗程的催产素鼻喷雾剂对改善ASD青少年社交行为的疗效。
在2009年2月至2012年1月期间于澳大利亚两个大学地点进行的一项双盲、安慰剂对照试验中,50名年龄在12至18岁之间、患有自闭症或阿斯伯格症的男性参与者被随机分配接受催产素(n = 26)或安慰剂(n = 24)鼻喷雾剂(18或24国际单位),每天给药两次,持续8周。在基线、治疗4周和8周后以及3个月随访时对参与者进行评估。主要结局指标是照料者完成的社会反应量表总分的变化以及临床医生在临床总体印象改善量表上的评分。次要评估包括照料者对重复及其他发育行为和社会认知的报告。
澳大利亚新西兰临床试验注册中心www.anzctr.org.au 注册号ACTRN12609000513213。
接受催产素治疗的参与者在主要和次要结局指标上均未显示出益处。然而,与认为自己孩子接受了安慰剂的照料者相比,认为自己孩子接受了催产素的照料者报告有更大改善。鼻喷雾剂耐受性良好,没有证据表明使用催产素会增加副作用。
这是对ASD青少年一个疗程催产素治疗疗效的首次评估。尽管结果未显示临床疗效,但需要进一步研究来探索替代给药方法、更早的干预年龄以及照料者期望对治疗反应的影响。