Psychopharmacological interventions in fragile X syndrome, fetal alcohol syndrome, Prader-Willi syndrome, Angelman syndrome, Smith-Magenis syndrome, and velocardiofacial syndrome

The utility of psychotropic drugs on patients with Fetal Alcohol Spectrum Disorder (FASD): a systematic review

“…The exact mechanisms leading to neuronal damage by alcohol during fetal life have not been fully elucidated, and many proposed mechanisms have been suggested based on experimental models [2]. It is well understood that alcohol commonly impairs the development of the dopaminergic, noradrenergic, serotonergic, cholinergic, glutamatergic, and histaminergic systems [6]. The dopamine D1 receptors of the meso-cortical system is the most impaired of the dopaminergic receptors [9].…”

“…Secondgeneration antipsychotics, which for the most part are serotonin-dopamine receptor antagonists, also possess anti-adrenergic and anti-histaminergic properties. These agents were used in the treatment of complications of seizure disorders associated with FASD [34], as adjunct therapy for Conduct Disorder [36], for disruptive behaviour in children with low IQ [5], and for secondary disabilities associated with FASD [6,18]. The most common antipsychotic drug used in children with FASD is Risperidone, which in some research has demonstrated strong benefits in the treatment of short-term aggressiveness [18].…”

“…A reference list of 10 randomly selected relevant articles (Doig et al [17]; Frankel et al [4]; Hagerman [6]; Ipsiroglu et al [3]; Kodituwakku [11]; Koren [2]; O'Malley and Nanson [9]; Ozsarfati and Koren [18]; Rowles and Findling [19]; Snyder et al [20]) was manually hand-searched to identify any further article that may be relevant. A snowball technique was also adopted, where citations within articles were searched if they appeared relevant to the systematic review (Ji and Findling [21]; Huizink [7]).…”

“…FASD is the most common form of prenatally acquired brain injury and affects about 4% of the Canadian population [3]. FASD is characterized by a wide range of clinical features, including a reduced Intelligence Quotient (IQ) [4,5], cognitive and learning disabilities, and severe behaviour challenges as well as impaired functioning [6,7]. Attention problems are prevalent, with approximately 50-90% of children with FASD also clinically diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) and/or Attention Deficit Disorder (ADD).…”

“…As such, simplistic approaches to medication treatment in FASD are lacking. Existing literature on psychopharmacological intervention and clinical responses in FASD and other comorbidities are based on case series and a handful of clinical trials [3,6]. The field lacks a logical step-by-step process to guide the pharmacological management of FASD, based on clinical evidence and/or effectiveness of these pharmacological therapies.…”