CHAPTER 8*
Medical Follow-up and Pharmacotherapy
Randi Jenssen Hagerman, M.D.

Introduction

The physician who follows children and adults with fragile X syndrome (FXS) must be familiar with the physical and behavioral problems associated with this disorder to provide optimal treatment and intervention. Although a cure does not presently exist, a variety of effective interventions are available. In the future, gene therapy or protein replacement therapy will be a reality. The difficulties that must be overcome before this type of therapy can be utilized in patients are discussed in chapter 12. At present, optimal intervention is a multiprofessional approach that includes academic and behavioral interventions (chaps. 9-11), individual motor and language therapy (chap. 10), and the physician's input in health maintenance and, when necessary, pharmacotherapy for behavior problems. The physician's perspective regarding treatment and follow-up are described in this chapter. Usually special education, individual therapy, and medication work synergistically to allow children with FXS to achieve their highest potential. Although significant behavior and attention problems are present in the majority of males with FXS and in significantly affected females, treatment must be individualized because the severity of the problems varies.

The first section of this chapter focuses on medical complications and their treatment. This section is divided into age groups, with an emphasis on what the physician should assess at each stage of development. The second section concerns the pharmacotherapy of behavior problems and medical problems, including seizures.

Brief Outline of Medical Follow-up and Pharmacotherapy

• Medical Follow-up
• Infancy
• The Toddler Period
• The Preschool Period
• The School-Age Period
• Early Adolescence
• Late Adolescence
• Pharmacotherapy
• The Treatment of Seizures and Mood Instability
• CNS Stimulants
• Clonidine
• Folic Acid
• Selected Serotonin Reuptake Inhibitors and Treatment of Aggression
• Antipsychotics
• Sleep Disturbances
• Combined Pharmacotherapy
• Future Prospects
• Conclusions and Acknowledgments
• References: A, B, C, D, EF, G, H, IJ, K, L, M, NOP, QR, S, T, UVWXYZ
• Detailed Outline of Medical Follow-up and Pharmacotherapy
• Medications Cited in Medical Follow-up and Pharmacotherapy
• Medical Conditions Cited in Medical Follow-up and Pharmacotherapy

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.

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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