Brief report: acamprosate in fragile X syndrome.

Doctors gave three adults with fragile X and autism a daily pill called acamprosate. They watched for any change in talking, social skills, and overall behavior for several weeks.

No placebo was used. The team simply tracked each person before and during the drug.

All three adults spoke more words and showed clearer sentences. Parents and clinicians also saw global improvement in mood and cooperation.

Laugeson et al. (2014) later tested the same drug in autistic youth without fragile X. Six of nine kids became less withdrawn, echoing the social gains seen here.

Brondino et al. (2016) reviewed every human trial of GABA or glutamate drugs in autism. They concluded evidence is still too thin to recommend any pill, including acamprosate. The review includes the 2010 case series, so the positive story you just read is part of the "not ready" pile.

Johnson et al. (2009) ran a matching open-label study with memantine, another glutamate drug, in fragile X youth. Only four of six improved, and two quit from irritability. Acamprosate looks kinder and possibly more effective, but both studies are tiny.

You now have a low-risk option to discuss with prescribers when adults with fragile X and autism hit a language plateau. Track words per minute and social initiations weekly; if no change appears after six weeks, the drug likely fails. Keep watching for future RCTs—this case series is only a green light for cautious trial, not standard care.