Kenneth Sokolski

Kenneth Sokolski, M.D. is a psychiatrist practicing in Orange County, California and Associate Adjunct Professor in the Department of Psychiatry and Human behavior at VA Medical Center Long Beach, California.^[1]

Education and career

Sokolski attended the University of California, Irvine, where he received his M.D. in 1987 and completed residency in Psychiatry and Human Behavior in 1991.^[2][3] He currently works in private practice as a psychiatrist, but continues to be associated with UCI mentoring medical students and residents at the Veterans Affairs Medical Center of Long beach. Dr. Sokolski has published or co-authored numerous articles on the psychopharmacology of various mental illnesses, such as bipolar disorder, schizophrenia, and autism.^[4][5][6]

Secretin Study

Of his many publications, one study has ignited profound fascination and controversy in books, newspapers and media.^[7][8] Karoly Horvath (University of Maryland) along with Sokolski, et al. coauthored “Improved Social and Language skills after Secretin Administration in Patients with Autism Spectrum disorders” in 1998.^[9] This seminal paper proposed that secretin was an effective treatment for autism. Secretin is a 27 amino acid polypeptide hormone secreted by the mucosa of the duodenum, and aids in the regulation the pH and numerous processes in the stomach. The Food and Drug Administration (FDA) approved secretin only for single-dose use in the diagnosis of certain gastrointestinal disorders.^[10]

Secretin rise to prominence as a cure for autism stems from the efforts of Victoria Beck and her autistic son, Parker Beck. In April 1996 Victoria took her son Parker (then age 3) to see a gastrointestinal specialist, Dr. Karoly Horvath of the University of Maryland Medical Center due to chronic diarrhea and constipation which began at when he was about six months.^[11] Medical condition such as gastrointestinal issues and seizure disorder are strongly associated with in Autistic children.^[12][13] Horvath sedated Parker, conducted an upper gastrointestinal endoscopy, and administered secretin intravenously (2 Cu/kg) as part of his standard diagnostic procedure. In the following days, Beck noticed a dramatic reduction in her son’s symptoms. Parker’s digestive difficulties improved, he began sleeping through the night, and begin speaking, although he had been virtually mute before.^[14]

Three months later Parker progress stalled, panicked Beck contacted the Autism Research Institute in San Diego founder, Bernard Rimland.^[15][16] Rimland’s influence changed the prevailing viewpoint of autism from an emotional illness to a neurodevelopmental disorder, but was controversial due to his support of the MMR vaccine (thiomersal)- Autism link and secretin therapy.^[17][18] Through Autism Research Institute, Kenneth Sokolski (then assistant clinical professor at UC Irvine) volunteered to help Victoria Beck after watching home videos of Parker remarkable improvement, and convinced a gastroenterologist to give secretin to his son Aaron (then age 7). Prior to secretin, “you couldn’t get him to look at you at all,” say Dr. Sokolski. After the dose, “he looked right in his therapist eyes.” Dr. Horvath, Sokolski, et al. published a paper on the results with Parker, Aaron Sokolski and another autistic child, in the Journal of the Association for Academic Minority Physicians.

Dr. Sokolski told the Wall Street Journal, “Aaron started regressing five weeks after the initial dose, and subsequent infusion have proved largely disappointing… There is a real effect. It is not our imagination. But it isn’t a magic cure for autism”.^[19] Mrs. Beck too noted that her son Parker regressed after about 5 weeks. Other IV infusion was performed 9 months after the first infusion, a third infusion 3 months after the second infusion. However, word of the secretin benefits quickly spread after Mrs. Beck appeared on the television program Dateline NBC on October 7, 1998, followed by a Good Morning America segment the next day.^[20] Jane Pauley from Dateline NBC television show called secretin therapy “a development some hail a breakthrough that may literally break the silence of autism”.^[21] These and other testimonials sparked a huge demand for off-label secretin use. Multiple Web sites started advertising secretin infusion at great cost.^[22] Alarmed by the claims of several thousand recipients of secretin for autism, numerous NIH supported clinical trials were conducted at the University of Washington, University of Colorado, the Universities of Chicago, Utah, Pittsburg, Pennsylvania, California at Irvine, and Harvard University.

The first formal report of the results of a controlled study of the use of secretin with autistic children appeared in the December 9, 1999 issue of the New England Journal of Medicine. Led Researcher, Adrian Sandler gave the article a title that expresses their findings “Lack of benefit of a single dose of synthetic human secretin in the treatment of autism and pervasive developmental disorder”.^[23] Researchers found no statistically significant differences between secretin and placebo groups. Sokoloski colleague, Bernard Rimland was skeptical of the shortcomings of the study and wrote in Autism Research review “there are at least 13 or 14 other studies of secretin in the pipeline that I know of. This is just the first half of the first inning. …. The bottom line: secretin is here to stay. Don’t let the naysayers discourage you”! ^[24]

Other researchers soon replicated equally similar negative results in different journals. A literature search of PubMed identified 15 randomized controlled trials (RCTs) examining the efficacy of secretin versus placebo published from 1999 and 2003. Investigators addressed different concerns and criticisms: 9 studies used porcine secretin,^{[25][26][27][28][29]} 5 examined the human synthetic form,^[30][31][32] 9 studies used cross-over designs,^[33][34][35] multiple doses were given in 2.^[36][37] These study consisted of various population size, age range, study length, and Autism diagnosis testing procedures.^[38][39] Regardless of the trial methodology, Secretin was no more effective than placebo in treating children with autism, including improving social skills, communication, behavior or global function.^[40][41]

References