Editor—More children are being diagnosed as having autism, and there are currently no treatments based on aetiology.1 Consequently, a number of controversial, unproved, alternative treatments have arisen. The recent death of an autistic child after a medication error with intravenous chelation therapy has brought one purported aetiology based treatment to international attention.2 The 5 year old child reportedly died from hypocalcaemia after receiving edetate disodium instead of edetate calcium disodium.3
Approved uses for chelation therapy include heavy metal poisoning in adults and children, although it has been used in an off-label manner for conditions such as coronary artery disease and Alzheimer's disease.4 Practitioners are using a variety of chelation agents and routes of administration for children with autism spectrum disorders, with oral dimercaprosuccinic acid, also known as succimer, probably the most common. Several of the agents are not approved for use or are given through an unlicensed route of administration such as rectal or transdermal.5
Available information about current use of chelation therapy in autism is scant, and what exists implies that inappropriate agents, routes, or dosage schedules of administration are being used as autism treatments. In addition, there is no compelling evidence to suggest that chelation therapy is an effective treatment for autism. A review of Medline (1966 to April 2006) and Premedline did not yield any relevant reviews or randomised controlled trials of chelation therapy for autism spectrum disorder.
Serious concern should arise about the ongoing use of chelation therapy in children with autism at this time, especially when the side effects of appropriate administration are well reported, a death has occurred with an error of administration, and the treatment incurs a cost for the families. The potential for vulnerable families to seek this as a promised miracle cure raises ethical and professional practice questions that need international consideration.
We thank Andis Graudins for his valuable review of the manuscript.
Competing interests: None declared.
References
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