Secretin as a Treatment for Autism: A Review of the Evidence

Abstract

Secretin is used in the United States for diagnosis of pancreatic gastrointestinal (GI) dysfunction and disease. Repeated therapeutic use has not been approved. Widespread interest in secretin as a treatment for autism followed media reports of behavioral improvements in an autistic child who received the hormone during a GI diagnostic procedure. International demand for secretin soared in the absence of experimental evidence of its efficacy for autism. This review presents a brief history of secretin's rise to popularity and summarizes research on secretin as a treatment for autism. Seventeen studies are reviewed comparing the effects of secretin forms, dosage levels, and dosing intervals on outcome measures with approximately 600 children. Twelve of 13 placebo-controlled studies failed to demonstrate the differential efficacy of secretin. Implications for advocating treatment in the absence of empirical evidence are discussed.

The cyclic AMP phenotype of fragile X and autism

“…Secretin is a neuropeptide that increases intracellular cAMP levels by activating adenylate cyclase upon binding its type II Gs coupled receptor, which has been linked to social behavior in mice (Nishijima, Yamagata et al 2006;Siu, Lam et al 2006). A case study (Horvath, Stefanatos et al 1998) reported improvement in autism behavior with infusion of secretin, although further clinical trials do not support the efficacy of this approach (Esch and Carr 2004;Sturmey 2005;Williams, Wray et al 2005). Based on these theories and the studies testing them, elevated cyclic AMP in CSF and peripheral blood may reflect a compensatory mechanism to increase low cAMP levels.…”

A Review on the Cognitive Neuroscience of Autism

“…Following publication of this study, secretin administration as a treatment option for autism was popularized after widespread media attention on television shows such as Dateline and Good Morning America. However, several comprehensive reviews of case reports and clinical trials have not concluded significant positive effects from secretin administration (Esch & Carr, 2004;McQueen & Heck, 2002;Sturmey, 2005).…”

Autism

“…Secretin provides a good example of how an incidental perception of behavioral improvement following treatment leads to widespread clinical use despite little or no scientific rationale for the therapy. And despite nearly unanimous negative results in placebo -controlled clinical trials (Esch & Carr, 2004), there still remains substantial parental interest in attempts at using secretin as a potential therapy. In many respects, this speaks to the desperate need of parents and practitioners alike to obtain more scientifically based approaches to the therapy of both the core and comorbid symptoms of autism.…”