Synopsis

Source of validity: Scientific
Rating (out of 5): 4

Dimercaptosuccinic acid (DMSA), also known as succimer, is a chelating agent with established scientific evidence supporting its use in the treatment of mercury poisoning, particularly for inorganic and elemental mercury exposures. DMSA works by binding to mercury ions in the body, forming water-soluble complexes that are excreted via the urine, thereby reducing the body burden of mercury. Clinical studies and case reports have demonstrated the efficacy of DMSA in enhancing urinary excretion of mercury and improving clinical outcomes in cases of poisoning. Its use is endorsed by major health authorities such as the U.S. Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) for certain types of mercury poisoning, especially when blood mercury levels are significantly elevated and/or symptoms are present.

DMSA is generally well tolerated with a favorable safety profile compared to older chelators like dimercaprol (British Anti-Lewisite, BAL). It is particularly preferred in children due to lower toxicity and oral administration. While DMSA is not effective for methylmercury (organic mercury) poisoning to the same extent, it remains an agent of choice for acute and subacute exposures to inorganic mercury. Systematic reviews and clinical guidelines support its use, although the overall quality of evidence is moderate due to the rarity of controlled trials in this clinical context. Nonetheless, DMSA’s use for mercury poisoning is grounded firmly in scientific validation and clinical practice.

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