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Oxytocin as a Treatment Enhancer in Anorexia Nervosa

Published online by Cambridge University Press:  23 March 2020

J. Russell ,
S. Maguire ,
A. Kesby ,
I. McGregor ,
A. O’Dell  and
J. Treasure
J. Russell
Affiliation:
Discipline of psychiatry university of Sydney Northside clinic, department of psychology, Greenwich NSW, Australia
S. Maguire
Affiliation:
University of Sydney, department of psychology, Sydney, Australia
A. Kesby
Affiliation:
University of Sydney, department of psychology, Sydney, Australia
I. McGregor
Affiliation:
University of Sydney, department of psychology, Sydney, Australia
A. O’Dell
Affiliation:
Discipline of psychiatry university of sydney northside clinic, department of psychology, Sydney, Australia
J. Treasure
Affiliation:
Kings college London, psychological medicine- the eating disorders research group, London, United Kingdom

Abstract

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Introduction

Nutritional rehabilitation in anorexia nervosa (AN) is impeded by fear of food, eating and change leading to treatment resistance. Oxytocin exerts prosocial effects on anxiolysis, fear modulation, trust and brain plasticity.

Objective

A placebo-controlled RCT examined the effects of self-administered intranasal oxytocin (IN-OT) in AN patients.

Aim

To ascertain whether single and repeated doses of IN-OT enhance treatment in AN.

Methods

Female AN patients self-administered twice daily 18IU IN-OT (n = 21) or placebo (n = 21) for 4–6 weeks during hospital treatment. Weight and BMI were measured at baseline and after treatment. The Eating Disorders Examination (EDE) was the primary outcome measure. Cognitive rigidity was compared between groups after four weeks repeated dosing. The effects of the first and last doses of IN-OT versus placebo, on salivary cortisol before a high-energy afternoon snack, were compared.

Results

Weight gain was similar in IN-OT and placebo groups. Only the EDE eating concern subscale score was significantly lower after 4–6 weeks (mean 35 days) of IN-OT (p = 0.006). Anticipatory levels of salivary cortisol fell from baseline after the initial dose in contrast to the placebo group where levels increased. After four weeks IN-OT, salivary cortisol was significantly lower (p = 0.023) overall with little anticipatory increase compared to placebo. There were no differences in anxiety scores. Cognitive rigidity was significantly lower in the IN-OT group (p= 0.043)

Conclusions

Self-administered IN-OT might enhance nutritional rehabilitation in AN by reducing eating concern and cognitive rigidity. Lower salivary cortisol before a high-energy snack, suggests reduction of fear rather than anxiety.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Type
Symposium: Reward processes in anorexia and bulimia nervosa: a new patogenetic model and future perspectives for treatment of eating disorders
Information
European Psychiatry , Volume 41 , Issue S1: Abstract of the 25th European Congress of Psychiatry , April 2017 , pp. S37
Copyright
Copyright © European Psychiatric Association 2017
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