Intranasal oxytocin may be a safe and effective pharmacological mechanism for improving effectiveness of trauma-focused psychotherapies—but caution is warranted.

The hormone oxytocin is well known for its effects on social and reproductive processes. Intranasal oxytocin (IN OT) has made a splash in the media and scientific community because of its potential for treating autism, schizophrenia, social anxiety and posttraumatic stress disorder (PTSD). While sometimes lauded as a panacea, IN OT is not without its critics (Leng & Ludwig, 2016), and for good reasons.

It is clinically well known that olfactory intrusions in PTSD can be a disabling phenomena due to the involuntary recall of odor memories. Odorants can trigger involuntary recall of emotional memories as well have the potential to help diminishing emotional arousal as grounding stimuli. Despite major advances in our understanding of the function of olfactory system, the study of the relation of olfaction and emotional memory is still relatively scarce.

Dr Halvorsen quite rightly draws attention to the various definitions of clinically significant change, which all have their advantages and disadvantages. We especially agree with the comment that the threshold for clinically significant change should at least coincide with the threshold for reliable change (18.66 in our sample).

Objectives: Sleep problems are a core feature in PTSD. However, a robust objective measure for the sleep disturbance has yet to be found. The current study assessed whether the spatial distribution of EEG spectral power in PTSD would provide such a measure.