Secretin in the Treatment of Autism

Article excerpt

Q My 9-year-old son has autism. His main problems are related to his lack of language skills and difficulty relating to others, especially if they are strangers or relatively unfamiliar to him. I saw a television news show recently about how the use of secretin in children who have autism has significantly improved their language and overall IQ. I have been unable to find any additional information on the Internet, except that most of the children who received it have improved in some way.

My son's doctor cannot find any studies in "peer reviewed journals." He is concerned about administering a drug that has not been approved by the FDA for use in treating autism.

Do you have any new information about the use of secretin in autism? I am concerned that my son will not benefit from it if he has to wait until he gets older. Also, do you think that insurance will cover the cost of the drug? No physician in our small town is willing to administer secretin, but I should be able to find a doctor in a nearby major city who will.

A I have received a number of questions regarding the use of secretin in children who have autism (or who have autistic spectrum disorders) over the last few months, primarily because of the publicity given to the subject by a national television news show and on a number of Internet sites. I hesitated to respond because I wanted to see what fell out after a few months. I do not feel that a television news show is always the best way to introduce a new use for a drug, or any substance for that matter, because of the limited amount of information that can be presented and for the misinformation that may also be presented. Subsequent to the show, however, there was a tremendous interest in the use of secretin in autism, not only by the public but by a number of physicians, experienced in the care of children who have autism and autistic spectrum disorders, who are capable of doing careful scientific research.

For those readers who may not be familiar with secretin, here is a brief overview. Secretin is a hormone that functions as a neurotransmitter (chemical messenger). It helps control digestion by increasing the volume of water and bicarbonate produced by the pancreas and secreted into the intestine. Secretin is generally used for diagnostic studies to evaluate the function of the pancreas and gallbladder, as well as such conditions as chronic diarrhea and malabsorption. Only one company that I am aware of produces porcine secretin. It is prepared from the duodenal mucosa (the internal lining of the first part of the intestine) of pigs.

As you are probably aware, it is not unusual for individuals who have autism to have gastrointestinal disorders, ranging from chronic diarrhea or constipation to apparent food intolerance. Three such individuals (ages 3 to 5 years) were evaluated for chronic diarrhea, and secretin was used in the diagnostic workup. Each of the children showed apparent improvement in social interaction, communication, behavior, interest, activities, and fine motor skills after their first and second doses of Secretin. This was reported in a medical journal and eventually on television and the Internet, leading to all the activity we are seeing now.

Consider the pros and cons

I have a few concerns regarding the form of secretin that is currently available. First, individuals using porcine (pig) secretin are using it "off label" (the FDA has not issued a formal approval because of inadequate documentation of safety and efficacy). I have prescribed many drugs which have been studied enough to make me comfortable using them "off label." I have not seen any published controlled studies documenting the efficacy of secretin in individuals who have autism. Anecdotal reports of various doses of secretin given by various providers will not lead to reliable and reproducible results and information.

My second concern arises because it is an animal product. …