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CNS Stimulants: Methylphenidate (Concerta)
Recently, a new long-acting methylphenidate preparation, Concerta, available in 18-mg, 36-mg, and 54-mg tablets, has been released. It is typically taken once per day in the morning with a unique
slow-release system. In our experience, Concerta has been effective for children with FXS and ADHD with fewer side effects, such as irritability or rebound in the late afternoon, compared to short-acting methylphenidate. All
stimulants work by stimulating dopaminergic and norepinephrine pathways (Raskin et al. 1984). They seem to stimulate inhibitory systems, allowing children to inhibit their responses to extraneous stimuli and stay focused on the
tasks at hand (Barkley 1997; Solanto 1998; Hagerman et al. 2001). Improved inhibition can also decrease impulsivity and hyperactivity. The overall effect is a child who is in better control of attention, impulsivity, and
hyperactivity. Auditory processing, reaction time, and even sensory integration and visual motor coordination are improved (DuPaul and Barkley 1990; Jerome 1995; Barkley 1997). Douglas et al. (1986) also showed academic
improvements, particularly in the accuracy and efficiency of academic tests in children with a normal IQ and ADHD who are treated with stimulants.
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This article is not intended to give medical advice for individual cases. Any change in medical treatment
should be done in consultation with appropriate medical personnel. This article is written for medical professionals. Some of the terms will be unfamiliar to those who are not trained in medical fields.
*This article is from the chapter on treatment in the 3rd edition of Fragile X Syndrome: Diagnosis, Treatment, and Research edited
by Randi Jenssen Hagerman, M.D. and Paul Hagerman, M.D., Ph.D., to be published May 2002. It is included with permission from The Johns Hopkins University Press. References to other chapters refer to chapters in
the book which are not included as part of this website.
The complete 3rd edition of Fragile X Syndrome: Diagnosis, Treatment, and Research can be ordered from the National Fragile X Foundation by calling
1-800-688-8765 or from The Johns Hopkins University Press at 1-800-537-5487.
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Medical Follow-up Pharmacotherapy Future Prospects
Outline Medications Medical Conditions
References: A, B, C, D, EF, G, H, IJ, K, L, M, NOP, QR, S, T, UVWXYZ
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