Secretin is an ineffective treatment for pervasive developmental disabilities: a review of 15 double-blind randomized controlled trials
Section snippets
Does secretin change behavior of children with PDDs?
All 15 papers reviewed reported no evidence, or almost no evidence, of an effect of secretin on behavior on any measure used. None of the 15 studies concluded that secretin was an effective treatment for autism. All studies used from 1 to 27 dependent variables derived from psychometric instruments. Most used multiple dependent variables while reporting almost no effects. This was true for a very wide range of measures that included core DSM-IV symptoms of PDD's, measures of maladaptive
Response of subgroups of children
It seems reasonable to suppose that, although there may be no overall benefit of secretin, that certain sub-groups of children with PDDs, especially those with GI symptoms, might benefit from secretin. At least four papers tested this hypothesis. Indeed the lack of and specific exclusion of children with GI symptoms might account for the lack of effectiveness reported in some of these trials.
Kern, Van Miller, Evans, and Trivedi (2002) provided the most explicit support for this hypothesis.
Discussion
This review of 15 double-blind, randomized, controlled trials of secretin for autism found almost no evidence for the effectiveness of secretin. It is difficult to prove the null hypothesis that secretin has no effects on the behavior of children with autism; effects may still be found for specific sub-populations, novel or more sensitive dependent variables, with larger samples or with different dosing regimes that have yet to be investigated. Nevertheless, it seems reasonable to conclude that
Acknowledgment
Rinita Laud generously assisted in the editing of this manuscript.
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