The neuropeptide oxytocin, commonly known as the "love hormone," which has been found to have potential benefit in a number of psychiatric disorders, may also be useful in the treatment of anorexia nervosa (AN).
In 2 studies headed by Youl-Ri-Kim, MD, PhD, Inje University in Seoul, South Korea, oxytocin was found to change the tendencies of patients with AN to fixate on images of high-calorie foods and larger body shape.
"Our research shows that oxytocin reduces patients' unconscious tendencies to focus on food, body shape, and negative emotions, such as disgust. There is currently a lack of effective pharmacological treatments for anorexia," Dr. Kim said in a statement.
"Our research adds important evidence to the increasing literature on oxytocin treatments for mental illnesses and hints at the advent of a novel, groundbreaking treatment option for patients with anorexia," Dr. Kim added.
The studies were published in Psychoneuroendocrinology and PLoS One on March 13 and March 6, respectively.
Janet Treasure, PhD, director, Eating Disorders Unit, and professor of psychiatry at the Institute of Psychiatry, Kings College, London, who is the senior author of both studies, told Medscape Medical News that she and her colleagues conducted the studies for several reasons.
"We know that people with anorexia nervosa have abnormal levels and function of oxytocin; we know that people with AN have abnormal social function, and this is related to oxytocin function; we know that people with AN treated with oxytocin for 4 weeks, from work done in Sydney, Australia, have a reduction in weight and shape concern; and finally, we know that oxytocin helps brain plasticity and stress, and that people with AN have shrunken, starved, stressed brains."
In the Psychoneuroendocrinology study, the researchers used a double-blind, placebo- controlled, within-subject crossover design.
Oxytocin or placebo was delivered via intranasal spray. This was followed by a visual probe detection task, during which patients were asked to look at images of high- and low-calorie foods, weight (scales), and body shape (fat or thin).
The sprays were administered to 64 women; 31 of the women had AN, and 33 served as control participants.
Once the images flashed on screen, the researchers measured how quickly participants identified the images.
The investigators found that the AN group showed significant reductions in the attention given toward eating-related stimuli (P = .030) and toward negative body shape stimuli (P = .015) when administered oxytocin.
The researchers also found that the effect of oxytocin was particularly strong in patients with AN who also had autistic spectrum traits, or greater communication problems.
In the PLoS One study, which involved the same participants and used a similar design, participants were given a similar test. But this time, the study tested the participants' reactions to facial expressions, such as anger, disgust, or happiness.
After taking a dose of oxytocin, patients with AN were less likely to focus on the disgust faces. They were also less likely to avoid looking at angry faces and became simply vigilant to them.
Dr. Kim cautioned that this research is in its early stages and had a small number of participants. But he added that "it's hugely exciting to see the potential this treatment could have. We need much larger trials on more diverse populations before we can start to make a difference to how patients are treated."
Dr. Treasure, who was awarded the Order of the British Empire for her work on eating disorders, told Medscape Medical News that, whatever the cause of AN, which is multifaceted and complex, the symptoms cause starvation, "and this impacts on brain function with progressive neural problems which gets people stuck the longer they have it. An early focus on the symptoms is essential for good recovery."
High Response Rate
Commenting on the study for Medscape Medical News, Forest Tennant, MD, PhD, who has studied oxytocin for use in patients with intractable, chronic pain at his Veract Intractable Pain Clinic in West Covina, California, applauded the fact that oxytocin is gaining a lot of interest for use in treatment of a variety of neurologic and pain disorders.
"Furthermore, a high percentage of patients positively respond," Dr. Tennant said. However, at this point it is unclear exactly how oxytocin works, he added.
"It appears that oxytocin is a type of 'homeopathic' agent in that it benefits neurologic problems that are seemingly disparate. I suspect that oxytocin works on a basic, underlying disease process such as neuroinflammation, which we now know underpins centralized pain and mood disorders."
Finally, oxytocin appears to be quite safe, Dr. Tennant said.
"We know from our pain work that it is a good adjunctive therapy in several pain and neurologic disorders."
Other recent studies of oxytocin reported in Medscape Medical News have shown the following:
A single dose of oxytocin administered via nasal spray enhances brain activity in key regions and temporarily improves social information processing in children with autism spectrum disorder.
Oxytocin dysfunction is seen in depressed mothers and their children.
A nasal spray of oxytocin can enhance the recognition of facial expressions, shifting attention from negative to positive information in women with borderline personality disorder.
The studies were funded by the National Research Foundation of Korea and the National Institute for Health Research Mental Health Biomedical Research Centre at South London, the Maudsley National Health Service Foundation Trust, and King's College, London. Dr. Kim, Dr. Treasure, and Dr. Tennant report no relevant financial relationships.
Psychoneuroendocrinology. Published online March 13, 2014. Abstract
PLoS One. Published online March 6, 2014. Full article
Medscape Medical News © 2014 WebMD, LLC
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Cite this: Oxytocin a Promising New Treatment for Anorexia - Medscape - Mar 18, 2014.