Homeopathy, is there nothing it can’t cure? Now, Neuro-Med, a company in Washington, USA, are selling a homeopathic treatment for autism: Respen-A, only available on prescription. Of course, I’m skeptical that a homeopathic treatment for anything can exist, let alone for autism, so I’m keen to find out more about this product.
For starters, the introduction in the manufacturers literature is quite worrying, as it lists vaccines (and thimerosal) as being implicated in the onset of autism, and does not provide references. So immediately, I get the impression that they are pandering to the antivax market. They then go on to try and link epidurals to autism, explain the benefits of a gluten free casein free diet, before finally arriving at the theory behind their treatment.
The active ingredient in Respen-A is reserpine, an indole alkaloid. It has been used to treat high blood pressure and the relief of psychotic symptoms. The manufacturers of Respen-A claim that high doses of reserpine can cause hyperactivity, irritability, inattentiveness, and depression, all of which are symptoms of autism. Following the homeopathic principal of “like cures like”, the manufacturers hypothesize that a low dose will alleviate the symptoms of autism. The resperine in Respen-A is diluted to 4X, which I believe is the same as 2C (1:10,000). If that is the case, there should be something in it!
What tests have been carried out on Respen-A? According to the manufactures website, a grand total of zero. Instead, they appear to be prescribing Respen-A (for a mere $82 for a 28-day supply), then inviting doctors and patients to submit data to the website.
Needless to say, this is not generally how a medicine goes from testing to sale. A medicine (certainly one of this nature) should go through a series of randomized double blinded placebo controlled trials to determine if the treatment is efficacious. According to the Respen-A Twitter account, these studies have not been done and all evidence for the effectiveness of Respen-A is anecdotal.
Is Respen-A a viable treatment for autism, or is it just another quacks attempt to con vulnerable parents out of their money for a “treatment” that offers nothing but false hope? I couldn’t possibly say. I don’t want to get sued.
Reserpine does pass into breast milk suggesting a degree of lipophillicity and so may well be bioavailable when administered via a topical patch, such as this is. It’s use as an anti-hypertensive is very mucky as it has the side effect of causing catecholamine depletion in the nervous system. This spawned the amine theory of depression, as patients treated with reserpine for their high blood pressure became depressed. It is not licensed in the UK because of this issue. Outside of hypertension it has a limited use in complex mental health disorders.
The stated concentration of the patch is 0.01 mg per disc. Whether this can have an effect depends on the bioavailability of reserpine through the skin (and I doubt very much that absorption and blood plasma levels have been studied).
Oral resperpine has a bioavailability of around 50%, with active doses in the range of 0.1 – 0.25 Mg (US Pharmacopoaeia). For children, there is experience of using from 20 ug/kg up to 0.25 mg daily. So the disc is 1/10 of the strength of the lowest dose oral tablet.
Hmmmmmmmm. Seems plausible. Not that it would treat autism. But plausible that in children this dose would be enough to invoke catecholamine depletion and therefore induce sedation and/or a state of anhedonia, apathy and motivational loss – depression.
But as the company haven’t bothered to do any dose-response or absorption/bioavailability studies, who can say? So relieved that British drug licensing laws and NHS procurement limits this kind of thing.
FDA information can be found here: http://www.drugs.com/pro/reserpine.html
No UK info unfortunately, due to the lack of license.