Figure 2.

Neurochemical effects of sertraline therapy in FXS. FMRP, BDNF, serotonin, and dopamine are all dysregulated in patients with FXS. Abnormal levels of FMRP and BDNF in FXS cause atypical dendritic morphology, LTD, LTP, and neurogenesis, all of which have been shown to normalize with serotonin application. Serotonin treatment may also directly benefit patients with FXS as an anxiolytic and by ameliorating defects in LTD, LTP and synaptic architecture. Sertraline may be an especially beneficial SSRI agent for FXS treatment because of its neurprotective effects and positive impact on language development. In addition, sertraline prevents reuptake of dopamine, another neurotransmitter thought to be dysregulated in FXS. Increasing dopamine levels in patients with FXS may help to improve hyperactivity and irregularities in LTP and dendritic morphology.