Open Access Highly Accessed Research article

Safety and efficacy of oral DMSA therapy for children with autism spectrum disorders: Part A - Medical results

James B Adams1*, Matthew Baral2, Elizabeth Geis3, Jessica Mitchell2, Julie Ingram3, Andrea Hensley3, Irene Zappia3, Sanford Newmark4, Eva Gehn3, Robert A Rubin5, Ken Mitchell3, Jeff Bradstreet26 and Jane El-Dahr7

Author Affiliations

1 Division of Basic Medical Sciences, Southwest College of Naturopathic Medicine, Tempe, AZ, USA

2 Department of Pediatric Medicine, Southwest College of Naturopathic Medicine, Tempe, AZ, USA

3 Autism Research Institute, San Diego, CA, USA

4 Center for Integrative Pediatric Medicine, Tucson, AZ, USA

5 Department of Mathematics, Whittier College, Whittier, CA, USA

6 International Child Development Resource Center, Phoenix, AZ, USA

7 Department of Pediatrics, Tulane University School of Medicine, New Orleans, LA, USA

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BMC Clinical Pharmacology 2009, 9:16  doi:10.1186/1472-6904-9-16

Published: 23 October 2009



This study investigated the effect of oral dimercapto succinic acid (DMSA) therapy for children with autism spectrum disorders ages 3-8 years.


Phase 1 involved 65 children who received one round of DMSA (3 days). Participants who had high urinary excretion of toxic metals were selected to continue on to phase 2. In phase 2, 49 participants were randomly assigned in a double-blind design to receive an additional 6 rounds of either DMSA or placebo.


DMSA greatly increased the excretion of lead, substantially increased excretion of tin and bismuth, and somewhat increased the excretion of thallium, mercury, antimony, and tungsten. There was some increase in urinary excretion of essential minerals, especially potassium and chromium. The Phase 1 single round of DMSA led to a dramatic normalization of RBC glutathione in almost all cases, and greatly improved abnormal platelet counts, suggesting a significant decrease in inflammation.


Overall, DMSA therapy seems to be reasonably safe, effective in removing several toxic metals (especially lead), dramatically effective in normalizing RBC glutathione, and effective in normalizing platelet counts. Only 1 round (3 days) was sufficient to improve glutathione and platelets. Additional rounds increased excretion of toxic metals.