Imipramine treatment of ADHD in a fragile X child

Hilton, David K.; Martin, Catherine; Heffron, William M.; Hall, Bryan D.; Johnson, Gregory L.

doi:10.1016/s0890-8567(10)80024-3

Cited by 9 publications

(4 citation statements)

References 14 publications

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“…Tricyclic antidepressants can also work well for bedwetting and sleep dysregulation [Hilton et al, 1991] although EKGs must be monitored as sudden death, presumed to be because of cardiac dysrythmias, has been described in some individuals with FXS, albeit rarely. Bupropion (Wellbutrin), which increases dopamine levels more than other antidepressants, can help with both focusing and mood/ anxiety issues and is not usually activating.…”

Section: Antidepressantsmentioning

confidence: 99%

Psychopharmacology in fragile X syndrome—Present and future

Berry‐Kravis

Potanos

2004

Ment. Retard. Dev. Disabil. Res. Rev.

138

135

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In addition to cognitive disability, fragile X syndrome (FXS) is associated with behavioral problems that are often functionally limiting. There are few controlled trials to guide treatment; however, available information does suggest that medications can be quite helpful for a number of categories of behavioral disturbance in FXS. Specifically, stimulants appear to be quite useful for management of distractibility, hyperactivity, and impulsive behavior; antidepressants help with anxiety, obsessive-compulsive behaviors and mood dysregulation; and antipsychotics can reduce aggression. These medications are supportive and help minimize dysfunctional behaviors and maximize functioning. As more is learned about the neural functions of FMRP, medications in the future will be expected to target specific synaptic mechanisms dysregulated in FXS brain and thus ameliorate the cognitive deficit with resultant behavioral improvements. This article summarizes knowledge about effectiveness and approaches to management of currently available psychopharmacology for behavior in FXS and discusses early leads to future treatments for cognition.

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Section: Antidepressantsmentioning

confidence: 99%

Psychopharmacology in fragile X syndrome—Present and future

Berry‐Kravis

Potanos

2004

Ment. Retard. Dev. Disabil. Res. Rev.

138

135

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“…Hilton et al [1991] documented the successful use of imipramine for reducing hyperactivity, increasing attention, and improving insomnia and enuresis in a boy with FXS. Hagerman [1996a] reported that although imipramine worked on several patients with FXS, it increased aggressive or outburst behavior in others.…”

Section: Introductionmentioning

confidence: 99%

Problem behavior in boys with fragile X syndrome

et al. 2002

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This study examines problem behavior over time in 59 boys with fragile X syndrome (FXS), aged 4-12 years, using the Child Behavior Checklist (CBCL). Approximately 49% of the boys scored within the borderline or clinical range on total problem behavior, while 56-57% scored in the borderline or clinical range on the attention and thought problems subscales, and 26% scored in this range on the social problems subscale. With a mean of 2.5 assessments per child, behavior problems were stable during the 3-year period of study. Total problem behavior was higher for children who displayed autistic behavior, were rated as low in adaptability, had mothers with higher maternal education levels, and were on medication. Mothers with more education also rated their children as having more attention, thought, and total problems. Children taking medication differed from boys who were not taking medication on social problems, but not on attention and thought problems. Low adaptability and more autistic characteristics predicted thought problems.

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“…For individuals who are too disinhibited on SSRIs, other antidepressants may be successful treatments that do not produce the disinhibited behavior and, in this study, had similar response rates when compared to the SSRIs. Tricyclic antidepressants can also work well for bedwetting and sleep dysregulation [31] although EKGs must be monitored, as sudden death, presumed due to cardiac dysrhythmias, has been described in rare individuals with FXS. Bupropion, which increases dopamine levels more than other antidepressants, can help with both focusing and mood/anxiety issues.…”

Section: Discussionmentioning

confidence: 99%

Clinic-Based Retrospective Analysis of Psychopharmacology for Behavior in Fragile X Syndrome

Berry‐Kravis

Sumis

Hervey

et al. 2012

International Journal of Pediatrics

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Fragile X syndrome (FXS) is associated with behavior that limits functioning, including distractibility, hyperactivity, impulsivity, hyperarousal, anxiety, mood dysregulation, and aggression. Medication response and side effect data were reviewed retrospectively for 257 patients (age 14 ± 11 years, range 4–60 years, 203 M, 54 F) attending an FXS clinic. Treatment success rates were defined as the percentage of positive response in the form of documented clinical report of improvement in the behavior(s) being targeted over at least a 6-month period on the medication, without side effects requiring medication discontinuance, while failures were defined as discontinuance of medication due to lack of clinical effectiveness or side effects. Success rate for treatment of targeted behaviors with trials of individual medications was 55% for stimulants, 53% for antidepressants, 62% for alpha2-agonists, and 54% for antipsychotics. With sequential trials of different medications in the same class, success rate improved to 73–77%. Side effect-related failures were highest for antipsychotics. Systematic psychopharmacologic intervention targeted to behavioral symptoms appears helpful in the majority of patients with FXS.

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Imipramine treatment of ADHD in a fragile X child

Cited by 9 publications

References 14 publications

Psychopharmacology in fragile X syndrome—Present and future

Psychopharmacology in fragile X syndrome—Present and future

Problem behavior in boys with fragile X syndrome

Clinic-Based Retrospective Analysis of Psychopharmacology for Behavior in Fragile X Syndrome

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