Synopsis

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

Dimercaptosuccinic acid (DMSA) is scientifically validated as an effective chelating agent in the treatment of chemical poisoning, particularly for heavy metals such as lead, mercury, and arsenic. DMSA acts by binding to these metal ions, forming water-soluble complexes that are then excreted in urine, thereby reducing the toxic burden in the body. Numerous controlled clinical studies have demonstrated its efficacy and safety in both children and adults exposed to lead. The U.S. Food and Drug Administration (FDA) has approved DMSA (marketed as Succimer) specifically for the treatment of lead poisoning in pediatric patients with blood lead levels above established thresholds. Additionally, the World Health Organization (WHO) includes DMSA in its Model List of Essential Medicines for the same indication. While evidence is strongest for lead poisoning, DMSA has also been used off-label for mercury and arsenic poisoning, with supportive animal studies and some clinical reports suggesting effectiveness. DMSA is preferred over older chelators like BAL (British Anti-Lewisite) and EDTA due to its oral bioavailability, relatively low toxicity, and favorable side-effect profile. Most guidelines and toxicology references recommend DMSA as a first-line treatment for moderate to severe heavy metal poisoning, making its use in chemical poisoning both scientifically justified and well-supported by high-quality evidence.

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