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Randomised trial, 2018

Does intranasal oxytocin help women with PMDD, and does early life trauma change the effect?

It depends on trauma history. In women with early life abuse, oxytocin worsened emotional symptoms. In women without early life abuse, oxytocin improved symptoms. This is preliminary evidence from a very small study.

Early or limited evidence 10 women (8 with PMDD, 2 with subthreshold PMDD); 5 with early life abuse before age 13, 5 without

What they did

Single-blind, placebo-controlled crossover trial with 10 women (8 with PMDD, 2 with subthreshold PMDD; 5 with early life abuse before age 13, 5 without). Participants received intranasal oxytocin or placebo during the premenstrual phase, then self-administered at home three times daily for 5 days or until menstruation, rating daily emotional symptoms.

What they found

Oxytocin effects differed by trauma history. Among women with early life abuse, oxytocin increased premenstrual emotional symptoms compared to placebo. Among women without early life abuse, oxytocin decreased symptoms.

What it means for you

Oxytocin's effectiveness for PMDD appears to depend on whether a woman experienced early life trauma. Women with trauma history may respond opposite to women without trauma. This is preliminary evidence from a very small sample (10 women total) and needs confirmation in larger studies before clinical use.

10

Total participants

8

With PMDD diagnosis

5

With early life abuse history

About the study

Original title
Early Life Abuse Moderates the Effects of Intranasal Oxytocin on Symptoms of Premenstrual Dysphoric Disorder: Preliminary Evidence From a Placebo-Controlled Trial
Authors
Walsh EC, Eisenlohr-Moul TA, Pedersen CA et al.
Journal
Frontiers in psychiatry
Year
2018
Study design
Randomised trial
Participants
8
What was tested
Intranasal oxytocin vs. placebo
Open access
Yes
Original abstract

Background: Although intranasal oxytocin (OXT) has been proposed to be a promising treatment for some psychiatric disorders, little research has addressed individual difference factors that may predict response to OXT. One such factor is early life abuse (ELA), which has widespread influences on social-emotional processing and behavior. This single-blind, placebo-controlled crossover trial examined the role of ELA in shaping the effects of intranasal OXT (vs. placebo) on daily behavioral symptoms in women with three or more prospectively-diagnosed cycling symptoms of premenstrual dysphoric disorder (PMDD). Methods: Participants were ten women with PMDD ( n = 8) or subthreshold PMDD ( n = 2), who had experienced ELA prior to age 13 ( n = 5) or no ELA ( n = 5). They completed two study visits during the late luteal (premenstrual) phase: once following administration of intranasal OXT and once following intranasal placebo (counterbalanced). Participants then self-administered OXT or placebo at home three times per day for 5 days or until menstrual onset, and prospectively rated daily emotional symptoms of PMDD. Power was adequate to detect medium main and interactive effects. Results: Among women with ELA, intranasal OXT (vs. placebo) increased the premenstrual emotional symptoms of PMDD, whereas among women without ELA, OXT decreased symptoms. Conclusion: This study adds to a growing literature highlighting the importance of considering historical social contexts and traits (such as ELA) as moderators of therapeutic response to OXT.

Reproduced under CC-BY.

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