For Boys With Fragile X Sydrome And ADHD, New Hope Found In Non-Stimulant Medication

The most common hereditary form of hereditary mental retardation is
known as Fragile X syndrome (FXS), so dubbed for its characteristic
mutation on the X chromosome, or Escalante's syndrome. Manifestations
of this disease in patients usually include a characteristic long
facial pattern, tooth and jaw misalignment, musculoskeletal
abnormalities, or autism.



Additionally, many FXS patients also suffer from attention
deficit
and/or hyperactivity disorder (ADHD), a disorder that can make
functioning socially or professionally difficult. Stimulant
medications, such as Ritalin®, are often effective for ADHD patients
with mental retardation, but there are counterproductive side effects
such as irritability, diminished speech, and social withdrawal.



L-acetyle carnitine (LAC,) a variant of the amino acid carnitine,
showed promise in a previous study of reducing hyperactive behavior in
FXS boys with AHDH. They were treated with it for one year, with no
adverse side effects reported. The same authors have subsequently
performed a andomized,
double-blind, placebo-controlled study over multiple centers to
determine how effective LAC can be in a larger group. This study will
be published in the April 1, 2008 issue of American Journal of Medical
Genetics Part
A, which is available online via Wiley InterScience at the
following address: 
http://www3.interscience.wiley/cgi-bin/jhome/33129.



M. Giulia Torrioli and Giovanni Neri of the Universit?  Cattolica in
Rome led the study, which brought together 51 boys between the ages of
6 and 12 who had been diagnosed with FXS and ADHD. They were treated in
one of eight facilities in Italy, France, and Spain. The treatment, 500
milligrams of LAC or a placebo twice a day, was continued for 12
months. A team of child neuropsychiatrists and psychologists evaluated
each patient at the start of the study, after one month, 6 months, and
12 months. Neuropsychologicial tests were used to evaluate the effects
of the drug and the placebo.



Subjects in the LAC group showed reduced hyperactive behavior and
better attention. In this group there were also no side effects,
indicating that LAC provides a safe alternative to stimulant therapies.
The placebo group showed less hyperactive behavior as well, but not at
the magnitude of the LAC group. Additionally, LAC patients showed
improved social ability. While both groups took intelligence tests, LAC
did not appear to improve intellectual function.



"We propose that
LAC be recommended as a treatment of ADHD in FXS children," the authors
state, "since it effectively reduces hyperactive behavior and
improves social abilities without adverse side effects." They also
suggest that these results may be applicable to children with autism,
who also do not easily tolerate stimulants.



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A
Double-Blind, Parallel, Multicenter Comparison of L-acetylcarnitine
with Placebo on the Attention Deficit Hyperactivity Disorder in Fragile
X Syndrome Boys

M. Giulia Torrioli, Silvia Vernacotola, Laura
Peruzzi, Elisabetta Tabolacci, Montserrat Mila, Roberto Militerni,
Sebastiano Musumeci, Feliciano J. Ramos, Mar?¬a Frontera, Giovanni
Sorge, Elisabetta Marzullo, Giusi Romeo, Louis Vallee, Edvige
Veneselli, Elena Cocchi, Eleonora Garbarino, Umberto Moscato, Pietro
Chiurazzi, Stefania D'Iddio, Menotti Calvani, Giovanni Neri

American Journal of Medical Genetics Part A, April
1st, 2008

DOI: 10.1002/ajmg.a.32268

Click
Here For Abstract



Written by Anna Sophia McKenney



View drug information on Ritalin LA.