A narrative exploration of oxytocin and anxiety in autism spectrum disorder

This review aims to critically examine the role of oxytocin in modulating anxiety within autism spectrum disorder by integrating molecular insights with clinical observations. A qualitative thematic analysis was undertaken, drawing on preclinical studies, genetic findings, and clinical trials published over the past two decades, with particular focus on oxytocin signalling pathways, receptor polymorphisms, and therapeutic applications. The analysis highlights that dysregulation of oxytocin levels, together with variations in the oxytocin receptor gene, contribute to heightened anxiety and social impairments in autism. Evidence from animal models and human studies indicates that exogenous oxytocin can reduce anxiety symptoms and improve social behaviours, though outcomes vary depending on genetic background, developmental stage, and methodological design. The review identifies heterogeneity in clinical phenotypes, short trial durations, and limitations in delivery systems as major obstacles to therapeutic translation. Taken together, the synthesis underscores the need for personalized approaches that combine biomarker identification, genotype-specific targeting, and optimized delivery methods. The central message is that while oxytocin holds promise as an anxiolytic agent in autism, its clinical utility depends on a rigorous translational framework that accounts for biological diversity and evidential sufficiency.