Secretin Use In Autism
by Peter W. Welty, M. D., F.A.A.P.
We have recently had many inquiries on the subject of autism. The Informed Parent has printed enlightened articles that you can find in the archives: “Autism and MMR Vaccine” by Dr. Louis Theriot, and “Directive for the Autistic Child” by Dr. Peter Welty.
Autism is a developmental behavioral disorder, where there is marked abnormal development in social interactions and communication, and a restricted repertoire of activities and interests. These behaviors are clearly evident before age three.
This disorder is difficult to diagnosis for parents and for doctors. Both are anxious to find any type of treatment which addresses these core concerns of social withdrawal, poor eye contact, and impaired social relationships.
Most of the medications used to address symptoms in autism simultaneously address many of the associated behaviors that occur with autism, such as aggression, anxiety, obsessive-compulsive symptoms, depression, or hyperactivity. Unfortunately, there are no know medications that address the core deficits of social and communication deficits.
Some medications in the past, notably naltrexone and fenfluramine, were found to improve some of the core symptoms, and even intelligence measures in some studies, but further detailed research failed to duplicate the early case report results.
Recently, some investigators have examined the use of secretin in the treatment of autism. Secretin is polypeptide found in the intestinal tract. Its function is to increase the secretion of digestive fluids from the pancreas, the production of bile from the liver and the production of pepsin from the stomach.
Porcine secretin, or secretin derived from pigs, has been traditionally used by doctors during GI endoscopy procedures, to better identify patients’ complaints. It was initially noted that there was dramatic improvement in three autistic children who were given porcine secretin during these GI procedures. The children were noted to have better eye contact, increased alertness, and improved language.
Since then, several major research centers have examined the role of porcine secretin in the treatment of the core symptoms of autism, and compared it with placebo, or sugar pill, in order to fully examine its effects. All of the tests had a dosing regimen that was randomized, and the trials were double-blind, which means that the parent, child, and doctor did not know which medication, the secretin or the sugar pill, the child was receiving during the trial.
All of the recent major research studies demonstrated that secretin was no different than sugar pill in addressing the core symptoms of autism. Although there were some limitations to the studies, at this time there does not appear to be strong evidence that secretin is a useful agent in addressing the symptoms of autism.
All of us, doctors and parents alike, are eager to find a treatment for this disorder. We will all keep searching. Until then it is important to stay involved with your local autism society which should have current updates on the treatment of autism.
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