A low dose of oxytocin (8 IU) delivered by a specialized nasal device significantly improved emotional face processing in autistic adults, while a higher dose showed no significant effect — the first dose-response study of oxytocin in autism.
8 IU beats 24 IUlow-dose oxytocin significantly improved emotion salience in autism (p=0.02, d=0.63) while the higher dose did not — challenging the assumption that more is better
What the researchers found
Low-dose intranasal oxytocin (8 IU) delivered via a novel Breath Powered device significantly increased emotional salience of faces in adults with autism (P=0.02, d=0.63, η²=0.18), while the higher dose (24 IU) did not reach statistical significance (P=0.12, d=0.4). Remarkably, the 8 IU effects occurred without significantly increasing blood plasma oxytocin levels, suggesting direct nose-to-brain delivery. No significant effects were found on other social-cognitive tasks (reading the mind in the eyes, emotional dot probe, face morphing).
Why it matters
Oxytocin research for autism has been hindered by inconsistent results, partly due to poor nasal delivery and unknown dose-response relationships. This is the first trial to show that less oxytocin may actually work better than more, and that a specialized delivery device can target the brain directly — potentially resolving why previous oxytocin trials in autism produced mixed results.
The numbers in context
n=17 · 8 IU vs 24 IU vs placebo · 8 IU: P=0.02, d=0.63 · 24 IU: P=0.12, d=0.4 · η²=0.18 · no blood plasma increase at 8 IU
How the study worked
Double-blind, crossover, randomized, placebo-controlled trial. 17 male adults with ASD received single doses of 8 IU oxytocin, 24 IU oxytocin, or placebo via a Breath Powered intranasal device in randomized sequence. After each dose, participants completed four social-cognitive tasks measuring emotion salience, emotion recognition, attentional bias, and face processing. Blood plasma oxytocin levels were measured.
Who was studied
17 male adults with autism spectrum disorder
What this study cannot tell us
Very small sample (n=17), all male. Single-dose crossover design cannot assess long-term effects or repeated dosing. Only one of four social-cognitive tasks showed significant improvement. The Breath Powered device is novel and not widely available. The finding of no plasma increase at the effective dose, while interesting, requires replication.
How to read the evidence
This is a well-designed double-blind, randomized, placebo-controlled crossover trial — a strong study design. However, the very small sample size (17 participants) and single-dose administration significantly limit the generalizability and clinical applicability of the findings.
When this study was published
Published in 2017, this was a pioneering dose-response study for oxytocin in autism. Subsequent research has continued to explore optimal dosing and delivery methods, informed by these findings.
The bigger picture
The oxytocin-autism field has been plagued by inconsistent results, with some trials showing benefit and others not. This study suggests two potential explanations: most trials may have used too-high doses, and standard nasal sprays may not deliver oxytocin efficiently to the brain. The Breath Powered delivery device and the finding that lower doses work better could reshape the field and explain previous contradictory results.
Questions still open
- Would repeated low-dose oxytocin treatment produce sustained improvements in social cognition in autism?
- Does the Breath Powered delivery device explain the results, or would standard nasal sprays at 8 IU produce similar effects?
- Would female or non-binary individuals with autism show the same dose-response pattern?
Common questions
What is oxytocin and why is it studied for autism?
Why did the lower dose work better than the higher dose?
Read the original research
Dose-dependent social-cognitive effects of intranasal oxytocin delivered with novel Breath Powered device in adults with autism spectrum disorder: a randomized placebo-controlled double-blind crossover trial.
Translational psychiatry, 7(5), e1136
Citation
Quintana, D S; Westlye, L T; Hope, S; Nærland, T; Elvsåshagen, T; Dørum, E; Rustan, Ø; Valstad, M; Rezvaya, L; Lishaugen, H; Stensønes, E; Yaqub, S; Smerud, K T; Mahmoud, R A; Djupesland, P G; Andreassen, O A. (2017). Dose-dependent social-cognitive effects of intranasal oxytocin delivered with novel Breath Powered device in adults with autism spectrum disorder: a randomized placebo-controlled double-blind crossover trial.. Translational psychiatry, 7(5), e1136. https://doi.org/10.1038/tp.2017.103