Open-label memantine in fragile X syndrome.

Six kids with fragile X and autism tried the drug memantine every day for a few months.

Doctors watched them openly—no placebo, no blinding—and used a simple 7-point scale to ask, 'Is the child better overall?'

Four of the six families heard the doctor say 'globally improved,' but formal checklists for language or repetitive behavior did not budge.

Two children had to quit early because the drug made them cranky and irritable.

Jones et al. (2010) ran the same open-label plan with a different glutamate drug, acamprosate, and also saw parent-noted gains in talking and social use.

Hall et al. (2022) later replaced pills with telehealth parent coaching. Their RCT showed big, lasting drops in irritability—without drug side effects—so the field has largely moved from ‘try a pill’ to ‘teach the family.’

Ferreri et al. (2011) proved you can cut fragile-X problem behavior in half using bedtime and errand-specific ABA packages, again beating the weak pill signal.

Memantine is safe to try, but expect only a gentle ‘global’ thumbs-up while real skill scores stay flat. Today you have stronger choices: parent-implemented FCT or bedtime protocols give faster, bigger, and side-effect-free gains. Save the drug slot for kids who fail good behavior plans first.