Display options
Cite
James S, Stevenson SW, Silove N, et al. Chelation for autism spectrum disorder (ASD). Cochrane Database Syst Rev. 2015;5:CD010766doi: 10.1002/14651858.CD010766.pub2.
James, S., Stevenson, S. W., Silove, N., & Williams, K. (2015). Chelation for autism spectrum disorder (ASD). The Cochrane database of systematic reviews, 5CD010766. https://doi.org/10.1002/14651858.CD010766.pub2
James, Stephen, et al. "Chelation for autism spectrum disorder (ASD)." The Cochrane database of systematic reviews vol. 5 (2015): CD010766. doi: https://doi.org/10.1002/14651858.CD010766.pub2
James S, Stevenson SW, Silove N, Williams K. Chelation for autism spectrum disorder (ASD). Cochrane Database Syst Rev. 2015 May 11;5:CD010766. doi: 10.1002/14651858.CD010766.pub2. Epub 2015 May 11. PMID: 26114777; PMCID: PMC6457964.
Copy Download .nbib Format: NLM
Share it on

Cochrane Database Syst Rev. 2015 May 11;5:CD010766. doi: 10.1002/14651858.CD010766.pub2. Epub 2015 May 11.

Chelation for autism spectrum disorder (ASD).

The Cochrane database of systematic reviews

Stephen James, Shawn W Stevenson, Natalie Silove, Katrina Williams

Affiliations

  1. Department of Research, Southwest Autism Research and Resource Center, 2225 N. 16th Street, Phoenix, AZ, USA.

PMID: 26114777 PMCID: PMC6457964 DOI: 10.1002/14651858.CD010766.pub2

Abstract

BACKGROUND: It has been suggested that the severity of autism spectrum disorder (ASD) symptoms is positively correlated with the level of circulating or stored toxic metals, and that excretion of these heavy metals, brought about by the use of pharmaceutical chelating agents, results in improved symptoms.

OBJECTIVES: To assess the potential benefits and adverse effects of pharmaceutical chelating agents (referred to as chelation therapy throughout this review) for autism spectrum disorder (ASD) symptoms.

SEARCH METHODS: We searched the following databases on 6 November 2014: CENTRAL, Ovid MEDLINE, Ovid MEDLINE In-Process, Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and 15 other databases, including three trials registers. In addition we checked references lists and contacted experts.

SELECTION CRITERIA: All randomised controlled trials of pharmaceutical chelating agents compared with placebo in individuals with ASD.

DATA COLLECTION AND ANALYSIS: Two review authors independently selected studies, assessed them for risk of bias and extracted relevant data. We did not conduct a meta-analysis, as only one study was included.

MAIN RESULTS: We excluded nine studies because they were non-randomised trials or were withdrawn before enrolment. We included one study, which was conducted in two phases. During the first phase of the study, 77 children with ASD were randomly assigned to receive seven days of glutathione lotion or placebo lotion, followed by three days of oral dimercaptosuccinic acid (DMSA). Forty-nine children who were found to be high excreters of heavy metals during phase one continued on to phase two to receive three days of oral DMSA or placebo followed by 11 days off, with the cycle repeated up to six times. The second phase thus assessed the effectiveness of multiple doses of oral DMSA compared with placebo in children who were high excreters of heavy metals and who received a three-day course of oral DMSA. Overall, no evidence suggests that multiple rounds of oral DMSA had an effect on ASD symptoms.

AUTHORS' CONCLUSIONS: This review included data from only one study, which had methodological limitations. As such, no clinical trial evidence was found to suggest that pharmaceutical chelation is an effective intervention for ASD. Given prior reports of serious adverse events, such as hypocalcaemia, renal impairment and reported death, the risks of using chelation for ASD currently outweigh proven benefits. Before further trials are conducted, evidence that supports a causal link between heavy metals and autism and methods that ensure the safety of participants are needed.

References

  1. Toxicol Environ Chem. 2011 May;93(5-6):1251-1273 - PubMed
  2. J Autism Dev Disord. 2007 Oct;37(9):1735-47 - PubMed
  3. Cochrane Database Syst Rev. 2002;(4):CD002785 - PubMed
  4. Clin Pharmacol Ther. 2010 Sep;88(3):412-5 - PubMed
  5. J Dent Res. 2000 Mar;79(3):868-74 - PubMed
  6. J Autism Dev Disord. 2006 Nov;36(8):1101-14 - PubMed
  7. Neuro Endocrinol Lett. 2006 Dec;27(6):833-8 - PubMed
  8. Toxicol Appl Pharmacol. 2006 Jul 15;214(2):99-108 - PubMed
  9. Maedica (Buchar). 2012 Sep;7(3):214-21 - PubMed
  10. J Toxicol Environ Health A. 2007 Oct;70(20):1723-30 - PubMed
  11. Cochrane Database Syst Rev. 2014 Jun 17;(6):CD004381 - PubMed
  12. Am Heart J. 2000 Jul;140(1):139-41 - PubMed
  13. Neurotoxicol Teratol. 1997 Nov-Dec;19(6):417-28 - PubMed
  14. Am J Dis Child. 1976 Jan;130(1):47-8 - PubMed
  15. J Alzheimers Dis. 2009;17(3):457-68 - PubMed
  16. Neurotox Res. 2013 Jan;23(1):22-38 - PubMed
  17. Neurotox Res. 2006 Aug;10(1):57-64 - PubMed
  18. Pediatr Ann. 2003 Oct;32(10):685-91 - PubMed
  19. Clin Pharmacol Ther. 1986 Dec;40(6):686-93 - PubMed
  20. BMJ. 2006 Oct 7;333(7571):756 - PubMed
  21. J Autism Dev Disord. 2009 Jul;39(7):996-1005 - PubMed
  22. Cochrane Database Syst Rev. 2011 Dec 07;(12):CD003681 - PubMed
  23. Toxicol Appl Pharmacol. 2004 Jul 15;198(2):209-30 - PubMed
  24. BMC Clin Pharmacol. 2009 Oct 23;9:16 - PubMed
  25. Cochrane Database Syst Rev. 2015 May 11;(5):CD010766 - PubMed
  26. Med Hypotheses. 2001 Apr;56(4):462-71 - PubMed
  27. J Altern Complement Med. 2007 Dec;13(10):1091-7 - PubMed
  28. Minerva Pediatr. 2012 Feb;64(1):27-31 - PubMed
  29. Arch Gen Psychiatry. 2011 Nov;68(11):1095-102 - PubMed
  30. Pediatrics. 2006 Aug;118(2):e534-6 - PubMed
  31. Biol Trace Elem Res. 2013 Feb;151(2):171-80 - PubMed
  32. Cochrane Database Syst Rev. 2011 Sep 07;(9):CD007849 - PubMed
  33. J Toxicol Environ Health A. 2007 Apr 15;70(8):715-21 - PubMed
  34. Cochrane Database Syst Rev. 2011 Nov 09;(11):CD007992 - PubMed
  35. Neurosci Biobehav Rev. 1990 Summer;14(2):169-76 - PubMed
  36. BMJ. 1997 Sep 13;315(7109):629-34 - PubMed
  37. Res Dev Disabil. 2006 Jan-Feb;27(1):70-84 - PubMed
  38. Lancet. 1982 Jul 10;2(8289):94-5 - PubMed
  39. J Autism Dev Disord. 2007 Apr;37(4):628-36 - PubMed
  40. Neuro Endocrinol Lett. 2002 Aug;23(4):303-8 - PubMed
  41. Cochrane Database Syst Rev. 2005 Oct 19;(4):CD003497 - PubMed
  42. Environ Health Perspect. 2010 Jan;118(1):161-6 - PubMed
  43. Science. 1973 Jul 20;181(4096):230-41 - PubMed
  44. Vet Hum Toxicol. 2002 Oct;44(5):274-6 - PubMed
  45. Int J Toxicol. 2003 Jul-Aug;22(4):277-85 - PubMed
  46. BMC Clin Pharmacol. 2009 Oct 23;9:17 - PubMed
  47. Curr Neurol Neurosci Rep. 2009 Mar;9(2):129-36 - PubMed
  48. Pediatrics. 1974 Nov;54(5):587-95 - PubMed
  49. Pediatrics. 2001 Jul;108(1):197-205 - PubMed
  50. JAMA. 2008 Nov 19;300(19):2236 - PubMed
  51. Neurotoxicology. 2008 Jan;29(1):190-201 - PubMed
  52. Mo Med. 1996 Mar;93(3):136-8 - PubMed
  53. Cochrane Database Syst Rev. 2008 Apr 16;(2):CD003498 - PubMed

Publication Types