Oxytocin for frontotemporal dementia: a randomized dose-finding study of safety and tolerability

Abstract

Objective: To determine the safety and tolerability of 3 doses of intranasal oxytocin (Syntocinon; Novartis, Bern, Switzerland) administered to patients with frontotemporal dementia (FTD).

Methods: We conducted a randomized, parallel-group, double-blind, placebo-controlled study using a dose-escalation design to test 3 clinically feasible doses of intranasal oxytocin (24, 48, or 72 IU) administered twice daily for 1 week to 23 patients with behavioral variant FTD or semantic dementia (clinicaltrials.gov registration number NCT01386333). Primary outcome measures were safety and tolerability at each dose. Secondary measures explored efficacy across the combined oxytocin vs placebo groups and examined potential dose-related effects.

Results: All 3 doses of intranasal oxytocin were safe and well tolerated.

Conclusions: A multicenter trial is warranted to determine the therapeutic efficacy of long-term intranasal oxytocin for behavioral symptoms in FTD.

Classification of evidence: This study provides Class I evidence that for patients with FTD, intranasal oxytocin is not significantly associated with adverse events or significant changes in the overall neuropsychiatric inventory.

© 2014 American Academy of Neurology.

Figures

Figure 1. Trial profile

Bid = twice a day.

Figure 2. Clinical efficacy measures

Scatter plots depicting individual patients' change in scores from baseline to day 7 of treatment according to treatment group in the combined oxytocin vs placebo groups for (A) NPI apathy domain, (B) FBI apathy domain, (C) IRI empathic concern scale, and (D) ACE-R. ACE-R = Addenbrooke's Cognitive Examination–Revised; FBI = Frontal Behavioral Inventory; IRI = Interpersonal Reactivity Index; NPI = Neuropsychiatric Inventory.