Abstract

Background: There is still no approved pharmacological therapy for the core symptoms of autism spectrum disorder (ASD). While there is some clinical evidence supporting the use of megavitamin therapy in ASD, its efficacy in older children with established ASD has yet to be studied. The potential adjunctive role of folinic acid, a biologically active folate derivative increasingly implicated in ASD neurodevelopment, has not previously been examined in combination with megavitamin and homeopathic approaches. Case Presentation: A 7-year-old male (34 kg) with grade 2 ASD diagnosed according to DSM-5 criteria presented after minimal functional progress with intensive specialized rehabilitation. His parents continued to be concerned with limited expressive speech, marked social withdrawal, and significant cognitive delay, with a baseline Childhood Autism Rating Scale, Second Edition (CARS-2 ST) score of 31. A 25-session parenteral protocol of B-vitamin megadoses, folinic acid, vitamin C, and the complex homeopathic preparation Coenzyme Compositum was administered over alternating weeks. Following protocol completion, the patient significantly improved across all assessed domains, with the CARS-2 ST score decreasing to 24. Conclusion: These findings extend the evidence base for integrative megavitamin approaches to older children with ASD and suggest a possible adjunctive role for folinic acid. Larger controlled trials are warranted.

Keywords

Autism Spectrum Disorder (ASD), folinic acid, leucovorin, megavitamin therapy, homeopathy, integrative medicine, CARS-2, treatment-refractory