Dimercaptosuccinic acid in the treatment of depression following lead exposure.
Am J Ind Med 1993 Dec; 24(6):701-706
A case of moderate to severe depression in a lead (7439921) worker that responded to dimercaptosuccinic-acid (DMSA) therapy was described. A 44 year old male was referred for possible toxic effects from occupational exposure to lead. He complained of depressed mood, fatigue, inability to concentrate, anhedonia, nightmares, and early morning awakening that had developed and worsened over 1 year. His occupational history included military service and work as a self employed bricklayer. At the age of 27 he started work in a lead battery manufacturing facility. Over the subsequent 17 years, he worked in most of the areas of the facility. He had not used a respirator until about 1 year prior to presentation. He typically wore his work cloths home without showering or changing them at the site. He did wear gloves at work, but he habitually bit his fingernails and may have ingested lead. Quarterly blood lead levels over the duration of employment were reviewed. The patient was offered DMSA chelation, which was extremely successful. The authors raise the possibility that DMSA may play a role in treating lead related depression. The authors submit three other explanations for the improvement. As depression is characterized by spontaneous remissions, the improvement may have occurred without any intervention. Since this report describes a single patient, the improvement may have been due to a placebo effect. The improvement may have been secondary to a decreased lead level in the central nervous system following DMSA treatment.
NIOSH-Publication; NIOSH-Cooperative-Agreement; NIOSH-Grant; Neurotoxic-effects; Medical-treatment; Lead-poisoning; Chelating-agents; Heavy-metal-poisoning; Battery-manufacturing-industry; Case-studies; Nervous-system-disorders
Community Medicine Mount Sinai School of Medicine One Gustave L Levy Place New York, NY 10029
Neurotoxic Disorders; Neurotoxic-effects
American Journal of Industrial Medicine
Mount Sinai School of Medicine, New York, New York