A survey of fluoxetine therapy in fragile X syndrome

Randi J Hagerman, M. J. Fulton, A. Leaman, J. Riddle, K. Hagerman, W. Sobesky

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42 Scopus citations


Fluoxetine is a selective serotonin reuptake inhibitor used in the treatment of aggression, depression, and other mood disorders. Low levels of serotonin in the central nervous system have been associated with a variety of problems including depression, aggression, obsessive-compulsive behavior, eating disorders, and panic disorders. Fluoxetine has been shown to be effective for many of these problems in the general population and in the developmentally disabled population. Males and females who are affected with the FMR-1 mutation commonly exhibit behavioral and emotional problems. Previous reports have shown that depression, anxiety, and schizoid features are common in the heterozygotes, and aggression is seen in approximately 30% of the affected males. This study surveys the effectiveness of fluoxetine treatment in all fragile X patients known in our clinic who have taken fluoxetine. Eighteen females with the FMR-1 mutation were treated with fluoxetine with an overall response rate of 83%. Ten out of 14 (71%) patients who had depression were helped. All patients who had problems with mood lability, panic attacks, and outburst behavior were improved. Three out of 4 patients (75%) with obsessive-compulsive symptoms were helped along with 5 out of 6 (83%) with anxiety. Persistent side effects were seen in 44%, and the most common were weight gain and weight loss. Seventeen males with fragile X syndrome were treated with fluoxetine for physical and/or verbal aggression. Overall, 12 out of 17 male patients (70.5%) were improved by fluoxetine treatment. Eleven were very much improved, and 1 was somewhat improved. In addition to aggression, the following symptoms in males also responded to treatment: mood lability (9 of 13, 69%), obsessive-compulsive symptoms (3 of 5, 60%), hyperactivity (5 of 6, 83%), depression (5 of 6, 83%), self-abuse (6 of 8, 75%), and anxiety (2 of 4, 50%). Persistent side effects were seen in 29.4%, and they included nausea. This survey suggests that fluoxetine is an effective and relatively safe medication for the treatment of depression and mood lability in heterozygotes and of aggression in males with fragile X syndrome. Further studies including controlled treatment trials of fluoxetine in fragile X syndrome are warranted.

Original languageEnglish (US)
Pages (from-to)155-164
Number of pages10
JournalDevelopmental Brain Dysfunction
Issue number2-3
StatePublished - 1994
Externally publishedYes


  • Aggression
  • Anxiety
  • Fluoxetine
  • Fragile X syndrome
  • Psychopharmacology
  • Selective serotonin reuptake blocker

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)


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