title: Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients.
abstract: There are currently few preventive interventions available for posttraumatic stress disorder (PTSD). Intranasal oxytocin administration early after trauma may prevent PTSD, because oxytocin administration was previously found to beneficially impact PTSD vulnerability factors, including neural fear responsiveness, peripheral stress reactivity, and socioemotional functioning. Therefore, we investigated the effects of intranasal oxytocin administration early after trauma on subsequent clinician-rated PTSD symptoms. We then assessed whether baseline characteristics moderated the intervention's effects.
  
  
  
  We performed a multicenter, randomized, double-blind, placebo-controlled clinical trial. Adult emergency department patients with moderate to severe acute distress (n = 120; 85% accident victims) were randomized to intranasal oxytocin (8 days/40 IU twice daily) or placebo (8 days/10 puffs twice daily), initiated within 12 days posttrauma. The Clinician-Administered PTSD Scale (CAPS) was administered at baseline (within 10 days posttrauma) and at 1.5, 3, and 6 months posttrauma. The intention-to-treat sample included 107 participants (oxytocin: n = 53; placebo: n = 54).
  
  
  
  We did not observe a significant group difference in CAPS total score at 1.5 months posttrauma (primary outcome) or across follow-up (secondary outcome). Secondary analyses showed that participants with high baseline CAPS scores receiving oxytocin had significantly lower CAPS scores across follow-up than participants with high baseline CAPS scores receiving placebo.
  
  
  
  Oxytocin administration early after trauma did not attenuate clinician-rated PTSD symptoms in all trauma-exposed participants with acute distress. However, participants with high acute clinician-rated PTSD symptom severity did show beneficial effects of oxytocin. Although replication is warranted, these findings suggest that oxytocin administration is a promising preventive intervention for PTSD for individuals with high acute PTSD symptoms.
authors.affiliation: Department of Psychiatry, Academic Medical Center, University of Amsterdam, , VU University Medical Center, Amsterdam. Electronic address: m.vanzuiden@amc.nl.
authors.forename: Mirjam
authors.initials: M
authors.lastname: van Zuiden
authors.affiliation: Department of Psychiatry, Academic Medical Center, University of Amsterdam, , VU University Medical Center, Amsterdam.
authors.forename: Jessie L
authors.initials: JL
authors.lastname: Frijling
authors.affiliation: Department of Psychiatry, Academic Medical Center, University of Amsterdam, , VU University Medical Center, Amsterdam.
authors.forename: Laura
authors.initials: L
authors.lastname: Nawijn
authors.affiliation: Department of Psychiatry, Academic Medical Center, University of Amsterdam, , VU University Medical Center, Amsterdam.
authors.forename: Saskia B J
authors.initials: SBJ
authors.lastname: Koch
authors.affiliation: Trauma Unit, Department of Surgery, Academic Medical Center, University of Amsterdam, , VU University Medical Center, Amsterdam.
authors.forename: J Carel
authors.initials: JC
authors.lastname: Goslings
authors.affiliation: Trauma Unit, Department of Surgery, Academic Medical Center, University of Amsterdam, , VU University Medical Center, Amsterdam.
authors.forename: Jan S
authors.initials: JS
authors.lastname: Luitse
authors.affiliation: Department of Surgery, VU University Medical Center, Amsterdam.
authors.forename: Tessa H
authors.initials: TH
authors.lastname: Biesheuvel
authors.affiliation: Department of Psychiatry, VU University Medical Center, Amsterdam; Department of Psychiatry, Onze Lieve Vrouwe Gasthuis Hospital West, Amsterdam.
authors.forename: Adriaan
authors.initials: A
authors.lastname: Honig
authors.affiliation: Arq Psychotrauma Expert Group, Diemen, Netherlands.
authors.forename: Dick J
authors.initials: DJ
authors.lastname: Veltman
authors.affiliation: Department of Psychiatry, Academic Medical Center, University of Amsterdam, , VU University Medical Center, Amsterdam.
authors.forename: Miranda
authors.initials: M
authors.lastname: Olff
mesh_terms: D000281:Administration, Intranasal; D000293:Adolescent; D000328:Adult; D000368:Aged; D004311:Double-Blind Method; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010121:Oxytocin / Q000008:administration & dosage* / Q000627:therapeutic use*; D013313:Stress Disorders, Post-Traumatic / Q000188:drug therapy*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D010121:Oxytocin
keywords: Early intervention; Intranasal oxytocin; PTSD; Prevention; Psychotrauma; RCT