Sorenson Kennet, Kendall Emilee, Grell Hannah, Kang Minjoo, Shaffer Christopher, Hwang Soonjo
Department of Psychiatry, University of Nebraska Medical Center, Omaha, NE 68198, USA.
Department of Pharmacy Practice, University of Nebraska Medical Center, Omaha, NE 68198, USA.
J Psychiatr Brain Sci. 2023;8(4). doi: 10.20900/jpbs.20230008. Epub 2023 Aug 31.
Endogenous neuropeptide Oxytocin (OXT) plays a crucial role in modulating pro-social behavior and the neural response to social/emotional stimuli. Intranasal administration is the most common method of delivering OXT. Intranasal OXT has been implemented in clinical studies of various psychiatric disorders with mixed results, mainly related to lack of solid pharmacodynamics and pharmacokinetics model. Due to intranasal OXT's mechanism of reducing the activation of neural areas implicated in emotional responding and emotion regulation, a psychopathology with this target mechanism could be potentially excellent candidate for future clinical trial. In this regard, irritability in youth may be a very promising target for clinical studies of intranasal OXT. Here we provide a mini-review of fifteen randomized controlled trials in pediatric patients with diagnoses of autism spectrum disorder (ASD), Prader-Willi syndrome (PWS), or Phelan-McDermid syndrome (PMS). Most studies had small sample sizes and varying dosages, with changes in irritability, mainly as adverse events (AEs). Neuroimaging results showed modulation of the reward processing system and the neural areas implicated in social-emotional information processing by intranasal OXT administration. Further research is needed to determine the most effective dose and duration of OXT treatment, carefully select target psychopathologies, verify target engagement, and measure adverse event profiles.
内源性神经肽催产素（OXT）在调节亲社会行为以及对社会/情感刺激的神经反应中起着关键作用。鼻内给药是输送OXT最常见的方法。鼻内OXT已在各种精神疾病的临床研究中应用，但结果不一，主要与缺乏可靠的药效学和药代动力学模型有关。由于鼻内OXT具有降低参与情绪反应和情绪调节的神经区域激活的机制，具有这种靶向机制的精神病理学可能是未来临床试验的潜在优秀候选对象。在这方面，青少年的易怒可能是鼻内OXT临床研究的一个非常有前景的目标。在此，我们对15项针对诊断为自闭症谱系障碍（ASD）、普拉德-威利综合征（PWS）或费兰-麦克德米德综合征（PMS）的儿科患者的随机对照试验进行了简要综述。大多数研究样本量小且剂量不同，易怒的变化主要作为不良事件（AE）。神经影像学结果显示，鼻内给予OXT可调节奖赏处理系统以及参与社会情感信息处理的神经区域。需要进一步研究以确定OXT治疗的最有效剂量和持续时间，仔细选择目标精神病理学，验证靶点参与情况，并测量不良事件特征。
