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Lack of Oxytocin Proved in People With a Vasopressin Deficiency

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The hormones oxytocin and vasopressin are produced in the same brain area and are also very similar in structure. People with a rare vasopressin deficiency cannot concentrate their urine and therefore lose liters of water. To compensate, they must drink up to ten or more liters per day.

These symptoms can usually be treated easily with a nasal spray or a tablet with artificially produced vasopressin. Nevertheless, even with this therapy, many patients suffer from anxiety disorders, have trouble with social interactions or with the perception of emotions in general.

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The reason for this could be a lack of oxytocin, colloquially known as the “cuddle hormone”. "Because the production of the two hormones is so close anatomically, disorders that lead to vasopressin deficiency could also affect the oxytocin-producing neurons," explains Dr. Cihan Atila, endocrinologist and first author of a study that has now been published in the journal "Lancet Diabetes and Endocrinology".

Oxytocin booster only works in healthy people

However, oxytocin is difficult to measure; a so-called stimulation test is required for a reliable statement. This stimulates oxytocin secretion, i.e. the release of this hormone in the body. One such stimulation substance is MDMA (3,4-methylenedioxy-N-methamphetamine), better known as ecstasy.

The researchers from the University of Basel and the University Hospital Basel, led by Prof. Dr. Mirjam Christ-Crain have now shown that in healthy people after a single dose of MDMA, the oxytocin level is 8.5 times higher, while it remained unchanged in people with a vasopressin deficiency. Accordingly, their oxytocin production also seems to be disturbed.

As expected, the increase in oxytocin in the healthy subjects on MDMA resulted in prosocial behavior and an increase in empathy, along with a reduction in anxiety symptoms. The patients with vasopressin deficiency, on the other hand, did not show any changes in these matters. "An oxytocin deficiency in people with vasopressin deficiency would at least partially explain this finding," says endocrinologist Atila.

Therapy with oxytocin?

"These results prove for the first time that a clinically relevant oxytocin deficiency actually exists. This finding opens up new therapeutic possibilities and could also be of interest for other diseases such as autism," says Mirjam Christ-Crain, head of the study and deputy head of endocrinology at the university hospital.

In addition, the results contribute to a deeper understanding that oxytocin is a key hormone for socio-emotional effects. The researchers at the Department of Clinical Research are currently planning a large study that will investigate whether therapy with oxytocin can improve the psychological symptoms in people with a vasopressin deficiency.

Reference: Atila C, Holze F, Murugesu R, et al. Oxytocin in response to MDMA provocation test in patients with arginine vasopressin deficiency (central diabetes insipidus): a single-centre, case-control study with nested, randomised, double-blind, placebo-controlled crossover trial. Lancet Diabetes Endocrinol. 2023;0(0). doi: 10.1016/S2213-8587(23)00120-1

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