Adjunctive intranasal oxytocin for schizophrenia: A meta-analysis of randomized, double-blind, placebo-controlled trials

Wei Zheng, Xiao Min Zhu, Qing E. Zhang, Xin Hu Yang, Dong Bin Cai, Lu Li, Xian Bin Li, Chee H. Ng, Gabor S. Ungvari, Yu Ping Ning, Yu Tao Xiang

Research output: Contribution to journalReview article

Abstract

Objective: Findings on the efficacy of intranasal oxytocin (IN-OT) in schizophrenia have been inconsistent. This meta-analysis of double-blind randomized controlled trials (RCTs) examined the efficacy and tolerability of adjunctive IN-OT in the treatment of schizophrenia. Methods: Standardized mean differences or risk ratios (SMDs or RRs) with their 95% confidence intervals (CIs) were used to synthesize the results of studies included in the meta-analysis. Results: Ten RCTs (n = 344) with 172 schizophrenia subjects on adjunctive IN-OT [range = 40–80 International Units (IU)/day] and 172 schizophrenia subjects on adjunctive placebo over 2–16 weeks were included. No significant differences regarding total psychopathology measured with the total Positive and Negative Syndrome Scale (PANSS) or the Brief Psychiatric Rating Scale (BPRS) [8 RCTs, n = 203; SMD: −0.08 (95%CI: −0.53, 0.37), P = 0.74, I 2 = 59%] and the positive, negative and general symptom scores [SMD: −0.20 to −0.04 (95%CI: −0.75, 0.36), P = 0.28 to 0.78; I 2 = 0% to 72%] were found between the IN-OT and placebo groups. Similarly, subgroup analyses for total psychopathology found no group differences. Dose-response effect analyses showed that only 80 IU/day IN-OT had superiority over placebo in improving total psychopathology (P = 0.02) and positive symptom score (P = 0.01). No group differences between adjunctive IN-OT and placebo regarding discontinuation due to any reason [RR: 1.12 (95%CI: 0.67, 1.88), P = 0.67, I 2 = 0%] and adverse drug reactions were found. Conclusions: Although the meta-analysis did not show a positive effect in general, the higher dose of adjunctive IN-OT (80 IU/day) appears to be efficacious and safe in improving total psychopathology and positive symptoms in schizophrenia. Review registration: CRD42017080856

Original languageEnglish
Pages (from-to)13-20
Number of pages8
JournalSchizophrenia Research
Volume206
DOIs
Publication statusPublished - 1 Apr 2019

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Oxytocin
Meta-Analysis
Schizophrenia
Placebos
Psychopathology
Confidence Intervals
Randomized Controlled Trials
Brief Psychiatric Rating Scale
Drug-Related Side Effects and Adverse Reactions
Odds Ratio

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Zheng, Wei ; Zhu, Xiao Min ; Zhang, Qing E. ; Yang, Xin Hu ; Cai, Dong Bin ; Li, Lu ; Li, Xian Bin ; Ng, Chee H. ; Ungvari, Gabor S. ; Ning, Yu Ping ; Xiang, Yu Tao. / Adjunctive intranasal oxytocin for schizophrenia : A meta-analysis of randomized, double-blind, placebo-controlled trials. In: Schizophrenia Research. 2019 ; Vol. 206. pp. 13-20.
@article{4478a307a4da46ff8572a8b023b98085,
title = "Adjunctive intranasal oxytocin for schizophrenia: A meta-analysis of randomized, double-blind, placebo-controlled trials",
abstract = "Objective: Findings on the efficacy of intranasal oxytocin (IN-OT) in schizophrenia have been inconsistent. This meta-analysis of double-blind randomized controlled trials (RCTs) examined the efficacy and tolerability of adjunctive IN-OT in the treatment of schizophrenia. Methods: Standardized mean differences or risk ratios (SMDs or RRs) with their 95{\%} confidence intervals (CIs) were used to synthesize the results of studies included in the meta-analysis. Results: Ten RCTs (n = 344) with 172 schizophrenia subjects on adjunctive IN-OT [range = 40–80 International Units (IU)/day] and 172 schizophrenia subjects on adjunctive placebo over 2–16 weeks were included. No significant differences regarding total psychopathology measured with the total Positive and Negative Syndrome Scale (PANSS) or the Brief Psychiatric Rating Scale (BPRS) [8 RCTs, n = 203; SMD: −0.08 (95{\%}CI: −0.53, 0.37), P = 0.74, I 2 = 59{\%}] and the positive, negative and general symptom scores [SMD: −0.20 to −0.04 (95{\%}CI: −0.75, 0.36), P = 0.28 to 0.78; I 2 = 0{\%} to 72{\%}] were found between the IN-OT and placebo groups. Similarly, subgroup analyses for total psychopathology found no group differences. Dose-response effect analyses showed that only 80 IU/day IN-OT had superiority over placebo in improving total psychopathology (P = 0.02) and positive symptom score (P = 0.01). No group differences between adjunctive IN-OT and placebo regarding discontinuation due to any reason [RR: 1.12 (95{\%}CI: 0.67, 1.88), P = 0.67, I 2 = 0{\%}] and adverse drug reactions were found. Conclusions: Although the meta-analysis did not show a positive effect in general, the higher dose of adjunctive IN-OT (80 IU/day) appears to be efficacious and safe in improving total psychopathology and positive symptoms in schizophrenia. Review registration: CRD42017080856",
keywords = "Augmentation, Meta-analysis, Oxytocin, Schizophrenia",
author = "Wei Zheng and Zhu, {Xiao Min} and Zhang, {Qing E.} and Yang, {Xin Hu} and Cai, {Dong Bin} and Lu Li and Li, {Xian Bin} and Ng, {Chee H.} and Ungvari, {Gabor S.} and Ning, {Yu Ping} and Xiang, {Yu Tao}",
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Adjunctive intranasal oxytocin for schizophrenia : A meta-analysis of randomized, double-blind, placebo-controlled trials. / Zheng, Wei; Zhu, Xiao Min; Zhang, Qing E.; Yang, Xin Hu; Cai, Dong Bin; Li, Lu; Li, Xian Bin; Ng, Chee H.; Ungvari, Gabor S.; Ning, Yu Ping; Xiang, Yu Tao.

In: Schizophrenia Research, Vol. 206, 01.04.2019, p. 13-20.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Adjunctive intranasal oxytocin for schizophrenia

T2 - A meta-analysis of randomized, double-blind, placebo-controlled trials

AU - Zheng, Wei

AU - Zhu, Xiao Min

AU - Zhang, Qing E.

AU - Yang, Xin Hu

AU - Cai, Dong Bin

AU - Li, Lu

AU - Li, Xian Bin

AU - Ng, Chee H.

AU - Ungvari, Gabor S.

AU - Ning, Yu Ping

AU - Xiang, Yu Tao

PY - 2019/4/1

Y1 - 2019/4/1

N2 - Objective: Findings on the efficacy of intranasal oxytocin (IN-OT) in schizophrenia have been inconsistent. This meta-analysis of double-blind randomized controlled trials (RCTs) examined the efficacy and tolerability of adjunctive IN-OT in the treatment of schizophrenia. Methods: Standardized mean differences or risk ratios (SMDs or RRs) with their 95% confidence intervals (CIs) were used to synthesize the results of studies included in the meta-analysis. Results: Ten RCTs (n = 344) with 172 schizophrenia subjects on adjunctive IN-OT [range = 40–80 International Units (IU)/day] and 172 schizophrenia subjects on adjunctive placebo over 2–16 weeks were included. No significant differences regarding total psychopathology measured with the total Positive and Negative Syndrome Scale (PANSS) or the Brief Psychiatric Rating Scale (BPRS) [8 RCTs, n = 203; SMD: −0.08 (95%CI: −0.53, 0.37), P = 0.74, I 2 = 59%] and the positive, negative and general symptom scores [SMD: −0.20 to −0.04 (95%CI: −0.75, 0.36), P = 0.28 to 0.78; I 2 = 0% to 72%] were found between the IN-OT and placebo groups. Similarly, subgroup analyses for total psychopathology found no group differences. Dose-response effect analyses showed that only 80 IU/day IN-OT had superiority over placebo in improving total psychopathology (P = 0.02) and positive symptom score (P = 0.01). No group differences between adjunctive IN-OT and placebo regarding discontinuation due to any reason [RR: 1.12 (95%CI: 0.67, 1.88), P = 0.67, I 2 = 0%] and adverse drug reactions were found. Conclusions: Although the meta-analysis did not show a positive effect in general, the higher dose of adjunctive IN-OT (80 IU/day) appears to be efficacious and safe in improving total psychopathology and positive symptoms in schizophrenia. Review registration: CRD42017080856

AB - Objective: Findings on the efficacy of intranasal oxytocin (IN-OT) in schizophrenia have been inconsistent. This meta-analysis of double-blind randomized controlled trials (RCTs) examined the efficacy and tolerability of adjunctive IN-OT in the treatment of schizophrenia. Methods: Standardized mean differences or risk ratios (SMDs or RRs) with their 95% confidence intervals (CIs) were used to synthesize the results of studies included in the meta-analysis. Results: Ten RCTs (n = 344) with 172 schizophrenia subjects on adjunctive IN-OT [range = 40–80 International Units (IU)/day] and 172 schizophrenia subjects on adjunctive placebo over 2–16 weeks were included. No significant differences regarding total psychopathology measured with the total Positive and Negative Syndrome Scale (PANSS) or the Brief Psychiatric Rating Scale (BPRS) [8 RCTs, n = 203; SMD: −0.08 (95%CI: −0.53, 0.37), P = 0.74, I 2 = 59%] and the positive, negative and general symptom scores [SMD: −0.20 to −0.04 (95%CI: −0.75, 0.36), P = 0.28 to 0.78; I 2 = 0% to 72%] were found between the IN-OT and placebo groups. Similarly, subgroup analyses for total psychopathology found no group differences. Dose-response effect analyses showed that only 80 IU/day IN-OT had superiority over placebo in improving total psychopathology (P = 0.02) and positive symptom score (P = 0.01). No group differences between adjunctive IN-OT and placebo regarding discontinuation due to any reason [RR: 1.12 (95%CI: 0.67, 1.88), P = 0.67, I 2 = 0%] and adverse drug reactions were found. Conclusions: Although the meta-analysis did not show a positive effect in general, the higher dose of adjunctive IN-OT (80 IU/day) appears to be efficacious and safe in improving total psychopathology and positive symptoms in schizophrenia. Review registration: CRD42017080856

KW - Augmentation

KW - Meta-analysis

KW - Oxytocin

KW - Schizophrenia

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U2 - 10.1016/j.schres.2018.12.007

DO - 10.1016/j.schres.2018.12.007

M3 - Review article

VL - 206

SP - 13

EP - 20

JO - Schizophrenia Research

JF - Schizophrenia Research

SN - 0920-9964

ER -