Mitchell Jennifer M, Arcuni Peter A, Weinstein Dawn, Woolley Josh D
Department of Neurology (JMM, DW), University of California San Francisco, San Francisco, CA; and Department of Psychiatry (JMM, PAA, JDW), University of California San Francisco, San Francisco, CA.
J Addict Med. 2016 May-Jun;10(3):182-9. doi: 10.1097/ADM.0000000000000213.
A pharmacotherapy that both improves social abilities and promotes abstinence may be particularly helpful for the treatment of alcohol use disorder. Recent clinical and preclinical evidence suggests that oxytocin has prosocial and antiaddiction effects. We performed a pilot, laboratory-based, preclinical trial of oxytocin in subjects with alcohol abuse (as per Diagnostic and Statistical Manual of Mental Disorders, 4 Edition criteria) to evaluate therapeutic potential and assess tolerability.
Social perceptual ability, cue-induced craving, and approach bias for alcohol and appetitive imagery were quantified after intranasal oxytocin and placebo administration to 32 nontreatment-seeking individuals with alcohol abuse in a double-blind, crossover study. Because attachment style can moderate the effects of oxytocin, we also explored whether attachment style moderated oxytocin's effects on our behavioral measures.
Oxytocin significantly improved recognition of easier items on a social perception task, but had no significant group-level effect on cue-induced craving. However, oxytocin effects on craving were moderated by attachment anxiety, with oxytocin reducing craving in more anxiously attached individuals and increasing craving in less anxiously attached individuals. Subjects did not display an approach bias to alcohol images on the placebo day, preventing meaningful analysis of this measure. Subjects did display an approach bias to appetitive images on the placebo day, which was significantly reduced by oxytocin administration. No adverse reactions were observed.
Intranasal oxytocin has potential to improve social perception, reduce cue-induced alcohol cravings, and reduce appetitive approach bias in subjects with alcohol abuse, and can be safely tolerated in this population. The effects of oxytocin are complex, however, and require further investigation.
一种既能改善社交能力又能促进戒酒的药物疗法可能对酒精使用障碍的治疗特别有帮助。最近的临床和临床前证据表明，催产素具有亲社会和抗成瘾作用。我们对患有酒精滥用的受试者（根据《精神疾病诊断与统计手册》第4版标准）进行了一项基于实验室的催产素临床试验，以评估其治疗潜力并评估耐受性。
在一项双盲、交叉研究中，对32名未寻求治疗的酒精滥用个体鼻内给予催产素和安慰剂后，对其社会感知能力、线索诱发的渴望以及对酒精和食欲意象的趋近偏向进行了量化。由于依恋风格可以调节催产素的作用，我们还探讨了依恋风格是否调节了催产素对我们行为指标的影响。
催产素显著提高了在社会感知任务中对较简单项目的识别能力，但对线索诱发的渴望没有显著的组水平影响。然而，催产素对渴望的影响受到依恋焦虑的调节，催产素减少了依恋焦虑程度较高个体的渴望，增加了依恋焦虑程度较低个体的渴望。在安慰剂日，受试者对酒精图像没有表现出趋近偏向，因此无法对该指标进行有意义的分析。在安慰剂日，受试者对食欲意象表现出趋近偏向，而催产素给药后这种偏向显著降低。未观察到不良反应。
鼻内给予催产素有可能改善社会感知、减少线索诱发的酒精渴望，并减少酒精滥用受试者的食欲趋近偏向，并且该人群可以安全耐受。然而，催产素的作用很复杂，需要进一步研究。
