De Cagna Francesca, Fusar-Poli Laura, Damiani Stefano, Rocchetti Matteo, Giovanna Gianluca, Mori Alessia, Politi Pierluigi, Brondino Natascia
Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, Catania, Italy.
Clin Psychopharmacol Neurosci. 2019 Feb 28;17(1):1-11. doi: 10.9758/cpn.2019.17.1.1.
Several studies have demonstrated the neuromodulating function of oxytocin (OT) in response to anxiogenic stimuli as well as its potential role in the pathogenesis of depression. Consequently, intranasal OT (IN-OT) has been proposed as a potential treatment of anxiety and depressive disorders. The present systematic review aimed to summarize the randomized controlled trials (RCTs) evaluating the effect of IN-OT on anxiety and depressive symptoms. Overall, 15 studies were included, involving patients with social anxiety disorders (7 studies), arachnophobia (1), major depression (3) or post-natal depression (4), and mainly evaluating single-dose administrations of IN-OT. Results showed no significant effects on core symptomatology. Five crossover studies included functional magnetic resonance imaging investigation: one trial showed reduced amygdala hyper-reactivity after IN-OT in subjects with anxiety, while another one showed enhanced connectivity between amygdala and bilateral insula and middle cingulate gyrus after IN-OT in patients but not in healthy controls. More studies are needed to confirm these results. In conclusion, up to date, evidence regarding the potential utility of IN-OT in treating anxiety and depression is still inconclusive. Further RCTs with larger samples and long-term administration of IN-OT are needed to better elucidate its potential efficacy alone or in association with standard care.
多项研究已证实催产素（OT）在应对焦虑源刺激时具有神经调节功能，以及其在抑郁症发病机制中的潜在作用。因此，鼻内催产素（IN-OT）已被提议作为焦虑症和抑郁症的一种潜在治疗方法。本系统评价旨在总结评估IN-OT对焦虑和抑郁症状影响的随机对照试验（RCT）。总共纳入了15项研究，涉及社交焦虑症患者（7项研究）、恐蛛症患者（1项）、重度抑郁症患者（3项）或产后抑郁症患者（4项），且主要评估IN-OT的单剂量给药情况。结果显示对核心症状无显著影响。五项交叉研究纳入了功能磁共振成像调查：一项试验表明，焦虑症患者在接受IN-OT后杏仁核过度反应性降低，而另一项试验表明，患者在接受IN-OT后杏仁核与双侧脑岛及扣带回中部之间的连接增强，但健康对照者未出现这种情况。需要更多研究来证实这些结果。总之，截至目前，关于IN-OT在治疗焦虑症和抑郁症方面潜在效用的证据仍不确凿。需要开展更多样本量更大且对IN-OT进行长期给药的RCT，以更好地阐明其单独使用或与标准治疗联合使用时的潜在疗效。
