Evidence supporting the use of: DMSA
For the health condition: Mercury Poisoning
Synopsis
Source of validity: Scientific
Rating (out of 5): 4
Dimercaptosuccinic acid (DMSA) is a chelating agent with validated clinical use in the treatment of mercury poisoning. DMSA works by binding to mercury ions in the body, forming water-soluble complexes that are excreted primarily in urine, thereby lowering mercury levels. The use of DMSA for mercury toxicity is supported by multiple animal studies and clinical trials, which demonstrate its effectiveness in increasing mercury excretion and reducing tissue mercury concentrations. The U.S. Food and Drug Administration (FDA) has approved DMSA (marketed as Succimer) for the treatment of lead poisoning in children, and it is also used off-label for mercury and arsenic poisoning, especially when standard therapies (such as dimercaprol/BAL) are contraindicated or less effective.
According to review articles and clinical guidelines, DMSA is preferred over BAL for elemental and inorganic mercury poisoning due to a more favorable safety profile and oral administration route. However, its efficacy for organic mercury (such as methylmercury) is less well established, and chelation therapy is generally reserved for symptomatic patients or those with high body burdens. Common side effects are mild (gastrointestinal symptoms, rash), but monitoring is required.
In summary, DMSA’s use in mercury poisoning is supported by scientific evidence and clinical practice, particularly for inorganic mercury exposures. Its use for organic mercury is more controversial and less robustly supported by high-quality evidence.
