Sertraline may improve language developmental trajectory in young children with fragile x syndrome: a retrospective
Tri Indah Winarni1, Weerasak Chonchaiya, Evan Adams
1Medical Investigation of Neurodevelopmental Disorders (MIND) Institute and Department of Pediatrics, University of California-Davis Medical Center, Sacramento, CA 95817, USA.
Insights
Sertraline treatment may improve language development in young children with fragile X syndrome (FXS). This study suggests a potential benefit for anxiety and language delays in FXS, warranting further controlled trials.
Area of Science:
- Pediatric Neurology
- Developmental Psychology
- Pharmacology
Background:
- Young children with fragile X syndrome (FXS) often exhibit anxiety, irritability, and hyperactivity due to sensory hyperarousal.
- Current treatment guidelines lack documented efficacy for pharmacotherapy in children under 5 with FXS.
- FXS is frequently associated with language delays and anxiety, impacting early development.
Purpose of the Study:
- To investigate the efficacy of sertraline in improving language development in young children with fragile X syndrome.
- To assess the impact of sertraline on anxiety and early learning composite scores in FXS patients under 5 years old.
- To provide preliminary data supporting a controlled trial for sertraline in this population.
Main Methods:
- Retrospective chart review of 45 children (12-50 months) diagnosed with fragile X syndrome.
- Comparison of 11 children treated with sertraline versus 34 untreated children.
- Assessment of language development using Mullen Scales of Early Learning (MSEL) for baseline and longitudinal evaluations.
Main Results:
- Children treated with sertraline showed a significantly higher mean rate of improvement in both expressive and receptive language development (P < 0.0001 and P = 0.0071, respectively).
- Baseline characteristics, including anxiety, language delays, early learning composite scores, and autism spectrum disorder incidence, were similar between groups.
- No significant differences in early learning composite scores were reported between treated and untreated groups.
Conclusions:
- Sertraline treatment appears to accelerate language development in young children with fragile X syndrome.
- The findings support the need for a controlled clinical trial to confirm sertraline's efficacy in this demographic.
- Sertraline may be a promising therapeutic option for managing language delays in pediatric FXS.
Abstract:
Young children with fragile X syndrome (FXS) often experience anxiety, irritability, and hyperactivity related to sensory hyperarousal. However, there are no medication recommendations with documented efficacy for children under 5 years old of age with FXS. We examined data through a chart review for 45 children with FXS, 12-50 months old, using the Mullen Scales of Early Learning (MSEL) for baseline and longitudinal assessments. All children had clinical level of anxiety, language delays based on MSEL scores, and similar early learning composite (ELC) scores at their first visit to our clinic. Incidence of autism spectrum disorder (ASD) was similar in both groups. There were 11 children who were treated with sertraline, and these patients were retrospectively compared to 34 children who were not treated with sertraline by chart review. The baseline assessments were done at ages ranging from 18 to 44 months (mean 26.9, SD 7.99) and from 12 to 50 months (mean 29.94, SD 8.64) for treated and not treated groups, respectively. Mean rate of improvement in both expressive and receptive language development was significantly higher in the group who was treated with sertraline (P < 0.0001 and P = 0.0071, resp.). This data supports the need for a controlled trial of sertraline treatment in young children with FXS.
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