Pharmacologic Interventions for Irritability, Aggression, Agitation and Self-Injurious Behavior in Fragile X Syndrome: An Initial Cross-Sectional Analysis.
Eleanor M Eckert, Kelli C Dominick, Ernest V Pedapati and 9 others
PMID 31468273WHAT IT FOUND
Among 415 people with Fragile X syndrome and irritability, aggression, agitation or self-injury, 180 were receiving medication.
Those treated were older, more often male, and had more severe intellectual disability and behavior problems. This does not show medication improved behavior.
Key findings
01Of 415 people with Fragile X syndrome and irritability, aggression, agitation or self-injury, 180 were receiving medication targeting these behaviors.
02People receiving medication were older, more often male, and had more severe intellectual disability, more irritability and greater social deficits than people not receiving medication.
03Antipsychotics were the most commonly used medication class, and clinicians reported adverse effects in 67 of 180 treated people, most often weight gain.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The analysis is cross-sectional and pilot, so it describes groups at one time point rather than treatment effects. Medication exposure was recorded at clinic visits only, so drugs started or stopped between visits may be missed. Drug dose, duration and the specific drug linked to each side effect were not reported, so side effect rates cannot be tied to a medication. Many IQ values were missing, including 221 subjects (53%), so IQ comparisons may be incomplete. The sample came from Fragile X clinics in major metropolitan areas, and families had to seek tertiary care, so it may not represent all people with Fragile X syndrome. Behavioral therapy use was not measured, so medication effects cannot be separated from concurrent behavioral interventions. Multiple comparisons were not corrected for, so some reported differences may be chance findings.
The easy way to misread this
Do not read this as evidence that medication improves irritability, aggression, agitation or self-injury. The paper describes medication use and reported side effects, not behavior change after treatment.