Date of Award

2019

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department

Physician Assistant Studies

Department Chair

Laura Levy, DHSc, PA-C

Abstract

OBJECTIVE: The objective of this selective EBM review is to determine whether or not intranasal oxytocin is an effective treatment for reducing disruptive behavior in individuals with Prader-Willi Syndrome.

STUDY DESIGN: This is a systematic review of two randomized controlled crossover trials and one randomized controlled pilot study, all of which were double-blind and placebo-controlled. All articles were peer-reviewed, written in English and published between 2011 and 2016.

DATA SOURCES: The three articles used in this systematic review were found in PubMed based on their relevance to the objective of the study, the inclusion of patient-oriented problems and published within the last 10 years.

OUTCOMES MEASURED: The outcomes measured for this review are the individual’s disruptive behavior and whether there was an improvement after administering intranasal oxytocin. One study used a questionnaire rated by parents of children with Prader-Willi Syndrome, another used a developmental behavior checklist version M to rate temper outburst and the last study scored disruptive behavior on a grid by a team of psychologists.

RESULTS: Two of the three studies demonstrated no statistically significant improvement in disruptive behavior in individuals with Prader-Willi syndrome.6,8 Kuppens et al. with no statistical significance demonstrated as group 6-11 years old had a p-value of 0.071 and age 11-14 with p-value of 0.109.6 Einfeld et al. demonstrated an increase in temper outbursts when a higher dose of oxytocin was administered with p-value of 0.01.7 Tauber et al resulted in statistically significant reduction in disruptive behavior in the late effect with p-value 0.031 but overall, the data documented no significance in the reduction of disruptive behavior.8

CONCLUSIONS: The use of intranasal oxytocin to reduce disruptive behavior is promising, however, the current data on the use of intranasal oxytocin to reduce disruptive behavior in individuals with PWS is inconclusive. Each study demonstrated a different conclusion on the data ranging from increasing disruptive behavior to decreasing disruptive behavior. Consequently, more research is needed in order to draw a formal conclusion on the use of intranasal oxytocin and its potential effects on behavior in individuals with Prader-Willi syndrome.

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Pediatrics Commons

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