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Unis AS, Munson
JA, Rogers SJ, Goldson E, Osterling J, Gabriels R, Abbott RD, Dawson GK
Department of Psychiatry and Behavioral Science, University of Washington,
Seattle, WA 98195, USA.
Abstract:
J Am Acad Child Adolesc Psychiatry 41:1315, 2002
Findings
Secretin is a hormone normally found in the
body that regulates the function in the small intestine and pancreas.
In recent years, many parents reported improvements in their autistic
children after giving them secretin by infusions (injections) or transdermally
(i.e., through the skin). It was thought that this hormone is somehow
not being produced at normal levels in children with autism, possibly
contributing to symptoms of the disorder.
Controlled studies examining the effects of secretin on symptoms of autism
have been published. While some of these studies reported a positive effect
on autistic behavior after infusion, final study outcomes indicated that
secretin, even repeated doses, was not more effective than a placebo
in improving the behavioral symptoms of autism.
Dr. Alan Unis and his colleagues at the University of Denver compared
the effects of a single does of secretin, both of biologic (from pigs)
and synthetic origin to placebo on a variety of autism symptoms. The reason
two different types of secretin were used was because there has been some
controversy about whether naturally occurring (biological) secretin is
different in effect than synthetic secretin (produced in the laboratory).
A total of 85 children with autism (aged 3-12 years) without other medical
conditions and not taking other medications were included in this study.
Children were grouped into three groups matched by age and communication
level and then randomly assigned to one of three treatment groups: biologic
secretin, synthetic secretin, or placebo. Measures collected 1 week before
and 4 weeks after infusion included autism symptoms, language skills,
and problem behaviors, gathered from parents, teachers, and investigators,
who were all "blind" to treatment (double-blind
trial).
Direct observation measures did not change over time in chidren treated
with secretin compared with placebo. Parents reported an overall reduction
of symptom severity for all treatment groups, including the placebo group.
One report from teachers described decreases in autism symptoms in the
placebo as well as the synthetic secretin groups.
Conclusions
Despite the many reports that secretin is
associated with improvement in symptoms of autism, this placebo-controlled,
double-blind trial showed no such effect. The authors found no evidence
that either biologic or synthetic secretin provided decrease of symptoms
beyond placebo.
The authors conclude that there is no compelling evidence for the use
of secretin for the treatment of autism, and that doctors are left with
more traditional psychological or pharmacolotical treatments that aim
to reduce symptoms.
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