title: A Randomized, Double-Blind, Placebo-Controlled Trial of Low-Dose Sertraline in Young Children With Fragile X Syndrome.
abstract: Observational studies and anecdotal reports suggest that sertraline, a selective serotonin reuptake inhibitor, may improve language development in young children with fragile X syndrome (FXS).
  
  
  
  The authors evaluated the efficacy of 6 months of treatment with low-dose sertraline in a randomized, double-blind, placebo-controlled trial in 52 children with FXS aged 2 to 6 years.
  
  
  
  Eighty-one subjects were screened for eligibility, and 57 were randomized to sertraline (27) or placebo (30). Two subjects from the sertraline arm and 3 from the placebo arm discontinued. Intent-to-treat analysis showed no difference from placebo on the primary outcomes: the Mullen Scales of Early Learning (MSEL) expressive language (EL) age equivalent and Clinical Global Impression Scale-Improvement. However, analyses of secondary measures showed significant improvements, particularly in motor and visual perceptual abilities and social participation. Sertraline was well tolerated, with no difference in side effects between sertraline and placebo groups. No serious adverse events occurred.
  
  
  
  This randomized controlled trial of 6 months of sertraline treatment showed no primary benefit with respect to early EL development and global clinical improvement. However, in secondary exploratory analyses, there were significant improvements seen on motor and visual perceptual subtests, the cognitive T score sum on the MSEL, and on one measure of social participation on the Sensory Processing Measure-Preschool. Furthermore, post hoc analysis found significant improvement in early EL development as measured by the MSEL among children with autism spectrum disorder on sertraline. Treatment appears safe for this 6-month period in young children with FXS, but the authors do not know the long-term side effects of this treatment. These results warrant further studies of sertraline in young children with FXS using refined outcome measures as well as longer term follow-up studies to address long-term side effects of low-dose sertraline in early childhood.
authors: *Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California, Davis Medical Center, Sacramento, CA; †Department of Occupational Therapy, Dominican University of California, San Rafael, CA; ‡Department of Neuroscience, The Ohio State University, Columbus, OH; §Department of Medicine, University of California, Irvine School of Medicine, Orange, CA; ‖Institute for Clinical and Translational Science, University of California, Irvine, CA; ¶Department of Psychology, University of California, Davis, Davis, CA; **Department of Pediatrics, University of California, Davis Medical Center, Sacramento, CA; ††Department of Special Education, California State University, Monterey Bay, CA; ‡‡Department of Psychiatry and Behavioral Sciences, University of California, Davis Medical Center, Sacramento, CA.
authors: Laura
authors: L
authors: Greiss Hess
authors: Sarah E
authors: SE
authors: Fitzpatrick
authors: Danh V
authors: DV
authors: Nguyen
authors: Yanjun
authors: Y
authors: Chen
authors: Kimberly N
authors: KN
authors: Gaul
authors: Andrea
authors: A
authors: Schneider
authors: Kerrie
authors: K
authors: Lemons Chitwood
authors: Marwa Abd Al Azaim
authors: MA
authors: Eldeeb
authors: Jonathan
authors: J
authors: Polussa
authors: David
authors: D
authors: Hessl
authors: Susan
authors: S
authors: Rivera
authors: Randi J
authors: RJ
authors: Hagerman
mesh_terms: D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D005260:Female; D005600:Fragile X Syndrome / Q000188:drug therapy*; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care / Q000379:methods*; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D020280:Sertraline / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*
chemical_list: D017367:Selective Serotonin Reuptake Inhibitors; D020280:Sertraline