There are many web sources singing the praises of herbs, vitamins and other alternative therapies for the treatment of autism. Do any of them work? Are they safe?
Researchers, led by Nicholas Lofthouse, PhD, of the Department of Psychiatry at Ohio State University, reviewed research studies for alternative treatments like supplements, vitamins and massage. They looked at safety, ease of use, effectiveness and cost.
The clear leaders were melatonin for sleep, multivitamins and massage.
dailyRx News spoke with Glen Elliott, MD, PhD, a child psychiatrist, about the content of this review article.
He said, “Professionals and parents seeking an even-handed, objective assessment of what is and is not known about a number of non-conventional interventions for individuals with autism and related disorders should find this article of considerable interest, though also frustrating.”
“The authors nicely summarize what has been published and make recommendations about safety and likely efficacy of 19 common interventions. It is striking how little information is available even with some of the oldest and most commonly used treatments.”
What is an alternative treatment?
The standard or accepted types of treatment for autism are medications, like antipsychotics, talk therapies and behavioral therapies.
The antipsychotics Risperdal (risperidone) and Abilify (aripiprazole) are currently the only drugs approved by the US Food and Drug Administration (FDA) for the treatment of autism. They are approved to treat irritability symptoms. Some ADHD meds, antidepressants, mood stabilizers (like lithium) and anti-anxiety meds are also used to treat specific symptoms in some children with autism.
School programs and behavioral therapies given by a licensed psychologist or social worker are also considered accepted treatments.
Alternative treatments are, then, therapies that are not specifically designed to treat autism or its symptoms but are used by some people. Alternative treatments are also those that fall outside the medical or psychological realm.
Many different alternative treatments have been in the news, like chelation therapy, animal therapy and many different vitamins. Much of the information available on the web about these treatments is not based on scientific evidence.
Why is scientific study important?
Many of these treatments may be harmless, but some may be dangerous if not monitored by a doctor. The only way to know if the risk is worth it is to also know if the treatment might actually be helpful.
Scientific studies look at the treatments to see what side effects there are, to see what symptoms might be helped and to compare them to other treatments.
By looking at scientific studies, parents and doctors can make more informed decisions about which treatments are best for a child with autism.
Recommended Alternative Therapies
Dr. Lofthouse’s review recommended the following alternative treatments because they seemed to be safe, effective and affordable.
- Melatonin – It can help with sleep and has few side effects.
- Multivitamin – They can help to overcome deficiencies in picky eaters. No side effects when used as directed. Three studies showed some improvement in symptoms like hyperactivity and gastrointestinal issues.
- Massage – Five studies found that it helped mood, anxiety, sensory issues and social skills. There is very little risk.
Acceptable Alternative Therapies
The following therapies were considered to be acceptable by Dr. Lofthouse and colleagues. They showed some benefit and had some risks. But they still may not be right for everyone.
- Vitamin B6 and magnesium supplements – These are good only if a child has a deficiency but can have some side effects, like diarrhea.
- Folic acid and omega 3 supplements – Studies showed some improvement in symptoms, like speech and hyperactivity. They are safe at recommended doses, but there is very little research on these.
- Probiotics– Only one trial has looked at these and it showed no benefit for autism symptoms. But they might be helpful if a child has stomach symptoms.
- Iron supplement – It may be good if a child has an iron deficiency. Otherwise, taking extra iron can be unsafe. One study did show that it improved sleep quality.
- Chelation – If a child has heavy metal toxicity, then it might be helpful. When no toxicity is present, this therapy can have nasty side effects like liver and kidney failure. Studies showed that it helped language and cognition but only when kids had heavy metal toxicity.
- Acupuncture – Three studies found that it helped with language and overall function. It is fairly safe, with only minor risk of infection. But it may be uncomfortable for some kids with sensory issues.
- Exercise – Adding exercise in some studies helped kids’ behavior and increased their academic performance. However, there are no controlled studies to show a clear-cut effect.
- Music therapy – There are very few studies, but the ones out there showed improved nonverbal communication. This therapy is not cheap or easy to find.
- Animal assisted therapy – Studies showed that it helped with language, mood and motivation. However, this type of therapy is not affordable or easy to access.
Alternative Therapies to Avoid
According to Dr. Lofthouse’s review, the therapies listed here were lacking in ways that make them unlikely to be helpful.
- L-carnosine supplements – There is not enough research either way on this one. This supplement can have side effects, like hyperactivity.
- Vitamin B12 supplement – There is not enough info on this one either. The only study out there used injections, which are not cheap or easy to get. It is not known whether oral supplements would work or not.
- Vitamin C in large doses – One study used very high doses (90 mg/kg) and it helped with repetitive behaviors. But these doses can get in the way of B12 absorption, leading to other problems.
- Cyproheptadine – It is an allergy medication that can have some risks. There is not enough evidence of benefit to outweigh the risk of side effects.
- Immune Therapy – Injections of immune globulin are designed to decrease immune system function. Six trials tested this, and only one found it to improve symptoms. It can be risky to mess with the immune system.
- Neurofeedback – The treatment focuses on re-training the brain. Five studies have shown that it improved social skills, language and attention. But it is not cheap or easy to access.
- Others that never showed any benefit in research: Auditory Integration Therapy, Facilitated Communication, Gluten/Casein-Free Diet, Hyperbaric Oxygen Therapy, and Secretin.
- Packing therapy– This is considered to be unethical and dangerous. Packing therapy confines kids by tightly wrapping them in cold, wet fabric.
Advice to Parents
The authors of this review said that many of these treatments may or may not be helpful. Much more research is needed for most of them. Until better info is available, here is their advice to parents:
- Always ask for evidence of safety and effectiveness on any commercially available treatment before you buy it. If they only provide stories, case reports, and testimonials – do not use it.
- Think about the money, time and effort in trying an alternative treatment and talk to a doctor about the risks.
- Talk to a doctor about any alternative treatments, even herbal ones. Even herbal remedies need to be monitored to make sure they don’t interact with other meds.
- Get educated. Talk to a doctor or seek web resources at places like the National Institutes of Health (http://nccam.nih.gov/), Autism Speaks (http://www.autismspeaks.org/) and the Autism Science Foundation (http://www.autismsciencefoundation.org/).
The review was published in the 2012 volume of Autism Research and Treatment. Funding information and conflicts of interest were not included with the article.
