New research reports that oxytocin, despite the hopes pinned on it by many, does not produce any signs of helping children with autism improve their social abilities.
Oxytocin is a naturally occurring hormone, and an important neurotransmitter (brain messenger molecule). It is more commonly known as the 'love hormone', is released by the pituitary gland, and seems to play a pivotal part in helping us bond socially and/or with our children. There has also been research that implicated oxytocin in the emergence of autism; the emergence of this disorder seemed to be correlated to a mutation on the oxytocin receptor gene (OXTR).
However, this link does not seem to hold up to scrutiny. Despite mixed results in regards to oxytocin's outcomes in improving social skills in children with autism in previous experiments, new research casts doubt on its potential. Although disappointing, such data will hopefully guide our attention to other, more promising candidate treatments.
Not the one
"There was a great deal of hope this drug would be effective," said the study's principal investigator and lead author, Linmarie Sikich, M.D., associate consulting professor in the Department of Psychiatry & Behavioral Sciences at Duke University School of Medicine. All of us on the study team were hugely disappointed, but oxytocin does not appear to change social function of people with autism."
Medically, oxytocin is administered mainly to help induce labor. But we do know that it functions as a neurotransmitter and, due to its effects on the workings of the brain, has been proposed as a treatment for autism. There was some evidence to back up this proposal, but it was inconsequential: some studies found it effective at the task, others reported it showed no benefit. Against this backdrop, Sikich's team set out to determine whether this hormone could have practical applications in the treatment of the disorder or not.
They worked with 290 children ages 3-17, which they separated into groups based on how severe their autism symptoms were. All children were then randomly assigned to equal-sized groups and received either oxytocin or a placebo, via daily nasal sprays, over a period of 24 weeks.
Each child underwent screenings and assessments of their social abilities at the start of the trial to establish a baseline. These were repeated at the midpoint and end of the trial, to track their progress (i.e. the effectiveness of the oxytocin regimen in improving their symptoms). In addition to these, the researchers and the children's parents also provided assessments using standard analytic tools for autism.
Overall, the authors explain that the oxytocin was well tolerated by the children and had few to no side effects. That being said, it didn't produce any meaningful effect in those who received oxytocin over those who were administered a placebo. Given that this is one of the largest studies looking into the effectiveness of the hormone in the treatment of autism, such findings do not bode well for its future as a treatment option.
"Thousands of children with autism spectrum disorder were prescribed intranasal oxytocin before it was adequately tested," says senior author Jeremy Veenstra-VanderWeele, M.D., of New York State Psychiatric Institute and Columbia University. "Thankfully, our data show that it is safe."
"Unfortunately, it is no better than placebo when used daily for months. These results indicate that clinicians and families should insist that there is strong evidence for the safety and benefit of new treatments before they are provided to patients in the clinic."
The team concludes, based on these findings, that there simply isn't enough evidence of oxytocin having any effect in this role. They add that there's too little here to even justify further research into its potential for treating autism spectrum disorders and that we should focus on more promising candidates instead.
Autism has taken up a large public interest in the last few years, maybe a decade or so. Personally, I think that part of this effect was caused by fear-mongering misinformation regarding vaccines (the famous 'vaccines cause autism' slogan). First off, I'd like to point out that autism itself is not as prevalent as we've been led to believe. Statistics do reveal broader trends than we'd be able to see using other means, but it can only be as effective and clear as the data we have on hand.
Still, for those whose loved ones might be on the spectrum, news such as this can definitely feel disheartening. I'd like to remind those of you who may be in such a position that autism is in no way a sentence to a bad life or to being shunned socially. Neurodivergent individuals can and do become valued, respected, and loved members of their social groups and wider societies. Their often unique skill sets and predispositions have been recognized and valued all throughout history.
There are certainly unique challenges that people with autism have to contend with. I have seen this through my own personal experiences with those who fall somewhere on the spectrum. Social skills can definitely be one of those more problematic areas. But I have also seen those who managed to overcome these issues, work around them, or find a way forward that makes them happy even without developing 'normal' social skills.
A treatment for autism would definitely be welcomed for those who desire it. But not having such treatment at hand is in no way a cause for despair. If you or someone you care for has to contend with autism, know that it is not a flaw that requires fixing. To be human is to be imperfect, and the measure of our lives is given by how well we can find happiness even through such imperfections.
The paper "Intranasal Oxytocin in Children and Adolescents with Autism Spectrum Disorder" has been published in the New England Journal of Medicine.