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CNS Stimulants
Attention deficits with or without hyperactivity are significant problems for almost all young males with FXS and for many females who are intellectually affected by FXS (chap. 1). Treatment for these
problems includes behavioral approaches, structure in the environment with positive reinforcement, as well as individual therapies, such as language therapy, occupational therapy, and cognitive behavior therapy (see chaps. 9, 10,
and 11). Medication can also significantly improve attention, concentration, impulsivity, and hyperactivity. A variety of medications improve ADHD symptoms, but the first-line medications for attentional problems are the CNS
stimulants.
Stimulants have been used to treat ADHD symptoms since Bradley's report of benzedrine's effectiveness in 1937. A dramatic increase in the use of stimulants occurred in the 1950s associated with the
development of other psychotropic medications, including antipsychotics and antidepressants. Although stimulant medication is commonly used for intellectually normal children with ADHD, stimulant use in children with cognitive
deficits has emerged over the last decade as well-designed studies demonstrating efficacy have been published (Handen et al. 1990, 1992, 1994, 1996, 2000; Mayes et al. 1994; Aman et al. 1991a, 1991b; Gillberg et al. 1997). Although
children with mild and moderate mental retardation and ADHD were included in these studies, there is evidence that children with severe mental retardation do not usually respond to stimulants (Aman 1982). Aman et al. (1991b) found
that IQ correlated significantly with response to methylphenidate and that an IQ below 45 was associated with a poor response.
CNS Stimulants: Continued
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This article is not intended to give medical advice for individual cases. Any change in medical treatment
should be done in consultation with appropriate medical personnel. This article is written for medical professionals. Some of the terms will be unfamiliar to those who are not trained in medical fields.
*This article is from the chapter on treatment in the 3rd edition of Fragile X Syndrome: Diagnosis, Treatment, and Research edited
by Randi Jenssen Hagerman, M.D. and Paul Hagerman, M.D., Ph.D., to be published May 2002. It is included with permission from The Johns Hopkins University Press. References to other chapters refer to chapters in
the book which are not included as part of this website.
The complete 3rd edition of Fragile X Syndrome: Diagnosis, Treatment, and Research can be ordered from the National Fragile X Foundation by calling
1-800-688-8765 or from The Johns Hopkins University Press at 1-800-537-5487.
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Medical Follow-up Pharmacotherapy Future Prospects
Outline Medications Medical Conditions
References: A, B, C, D, EF, G, H, IJ, K, L, M, NOP, QR, S, T, UVWXYZ
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