Intranasal oxytocin administration prior to exposure therapy for arachnophobia
impedes treatment response.
Author(s): Acheson DT(1), Feifel D(1), Kamenski M(1), Mckinney R(1), Risbrough VB(1,)(2).
Affiliation(s): Author information:
(1)Department of Psychiatry, University of California, San Diego, La Jolla, San
Diego, California. (2)Center for Excellence in Stress and Mental Health, VA San
Diego Healthcare System.
Publication date & source: 2015, Depress Anxiety. , 32(6):400-7
BACKGROUND: Recent years have seen the emergence of a new paradigm for treatment
of anxiety disorders focusing on development of drugs that facilitate
psychotherapies via targeted effects on neuroplasticity. One compound that has
generated interest in this regard is oxytocin (OT), a mammalian neuropeptide that
modulates activity of the neurocircuit mediating fear extinction and memory
processes. Recent research in healthy humans has suggested that intranasal OT
administered prior to fear extinction training enhances fear extinction
performance, supporting its potential to augment exposure-based psychotherapy.
Here, we tested the hypothesis that OT treatment would facilitate response to
exposure therapy in patients with specific phobia.
METHODS: We conducted a small proof-of-concept trial investigating the effect of
pretreatment intranasal OT administration on a brief, single-session exposure
treatment for arachnophobia (fear of spiders). The study was randomized,
double-blind, and placebo controlled (n = 13 placebo, 11 females; n = 10 OT, 8
females) with 1-week and 1-month follow-up assessments. Dependent measures
attended to arachnophobia symptoms (self-report), phobic behavior (behavioral
avoidance of spider task), and treatment credibility/therapeutic alliance.
RESULTS: Administration of OT prior to exposure therapy tended to impede
treatment response as measured by self-report of symptoms at both follow-up
periods. OT treatment did not significantly affect behavioral measures of fear.
Immediately after OT administration but before therapy, the OT group trended
toward less confidence in the treatment. The OT group also trended toward lower
ratings of therapeutic alliance than placebo.
CONCLUSIONS: These results suggest that OT administration effects on extinction
may vary depending on conditions and population.
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