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Psychiatry & Oxytocin

Psychiatry & Oxytocin. דר' אורי יצקר- רמב"ם 13/7/2010. Oxytocin. רקע פרסומים בין "הארץ" ל- Nature הדרך לפסיכיאטריה. אפשרויות וכיוונים מחקריים ויישומיים. neuropeptide Oxytocin. Cys-Tyr-Ile-Gln-Asn-Cys-Pro-Leu-Gly-NH2 Cys-Tyr- Phe -Gln-Asn-Cys-Pro- Arg -Gly-NH2. Oxytocin.

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Psychiatry & Oxytocin

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  1. Psychiatry& Oxytocin דר' אורי יצקר- רמב"ם 13/7/2010

  2. Oxytocin • רקע • פרסומים בין "הארץ" ל- Nature • הדרך לפסיכיאטריה. • אפשרויות וכיוונים מחקריים ויישומיים.

  3. neuropeptideOxytocin Cys-Tyr-Ile-Gln-Asn-Cys-Pro-Leu-Gly-NH2 Cys-Tyr-Phe-Gln-Asn-Cys-Pro-Arg-Gly-NH2

  4. Oxytocin • Hypothalamus Neurohypophysis Circulation. Hypothalamus • Paraventricular Amygdala Hyppocampus Nucleus accumbens • central and peripheral effects as a neurohormone, neurotransmitter and neuromodulator.

  5. Trust game & Risk game

  6. Ernst F. et al NEURON 2008 Ernst F. et al NEURON 2008

  7. Ernst F. et al NEURON 2008

  8. Ernst F. et al NEURON 2008

  9. NIMH Genes, Cognition and Psychosis Program

  10. Mother-infant bonding • Breast feeding • Held by mother, closeness. • Warmth • Maternal behavior. • CD38

  11. Mother-infant bonding • Cross-generation transmission of social affiliation. • Women with exposure to childhood abuse & OT levels. • Association between OT receptor gene (OXTR) & temperament.

  12. Sexual behavior • Released during arousal. • Administration into VTA erections. • Resistant anorgasmia.

  13. Well-being • Trust. • Reduced fear. • Social interactions. • Gaze to the eye region. • AmygdalaGABAergic neurons . • Connectivity between amygdala and brainstem.

  14. Well-being • Sympathetic response. • Mentalization. • Memories. • Cortisol levels. • Best friend.

  15. Neuroendocrine • Blood pressure. • Cortisol. • Insulin. • Endogenous opioids. • Sympathoadrenal “fight-flight”. • Hypnosis, meditation. • Pain, wound healing.

  16. Psychiatry • Autism. • Schizophrenia: OT levels, negative symp, Clozapine, PCP OT • Depression: OT levels, SSRI action, OT-5HT. • Social phobia. • borderline personality dis. • Fibromyalgia. • OCD.

  17. EFFECTS OF INTRANASAL OXYTOCIN IN PATIENTS WITH POST TRAUMATIC STRESS DISORDER:A SINGLE DOSE, DOUBLE BLIND CROSSOVER PILOT STUDY Yatzkar U. Krivoy N. Klein E

  18. goal • The aim of this pilot study was to assess the effect of a single dose of oxytocin administrated intranasally on PTSD symptoms.

  19. SUBJECTS AND METHODS • 18 subjects with PTSD. • Inclusion criteria (e.g. ages 20-65, no treatment change has been made within the preceding month). • Exclusion criteria (e.g. history of asthma, nasal polyps, allergy of any kind, pregnancy, cardiac arrhythmias, heart failure, hyponatremia)

  20. SUBJECTS AND METHODS • 24IU, Syntocinon spray, Novartis / saline solution. • The order of the treatments was randomized.

  21. SUBJECTS AND METHODS • PTSD Symptom Scale (PSS) . • Hopkins Symptom Checklist-25 (HSCL) • prior to treatment and 50 minutes after the treatment. • אבל...

  22. SUBJECTS AND METHODS • Visual Analogue Scale (VAS ) rating their feelings on a 1-10 scale. • Anxiety. • recurrent. • Mood. • Social interactions. • Tension.

  23. VASAnxiety

  24. VAS Depressed Mood *p<0.01

  25. VAS- Recurrent thoughts about the traumatic event

  26. VAS- Tension, restlessness and irritability *p<0.01

  27. CONCLUSIONS • This pilot study shows that intranasal administration of oxytocin improved several core symptoms in patients with PTSD. • Further studies are required to explore the potential therapeutic effect of oxytocin in patients with PTSD. • Conflict of interest-None

  28. מגבלות • מדגם קטן. • טיפול חד פעמי. • משמעותי סטטיסטי, האם משמעותי קליני? • מספר מטופלים הגיבו באופן ניכר בעוד אחרים לא הגיבו כלל. (בדיקת רמה).

  29. לאן מכאן?

  30. תודה

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