Promising therapeutic approaches in Down Syndrome: addressing parents' doubts

Background and Objective: New therapies are emerging to improve intellectual disability (ID) in Down syndrome (DS) and caregivers seek clarifications from medical providers. The aim of this study is to review pharmacological and non-pharmacological therapeutic targets in DS, with emphasis on postnatal therapies and their potential clinical use. Data source: A narrative review was conducted including studies in English, published before January 2022, on patients under eighteen years of age. Search strategy was developed using the keywords of this review. Data synthesis: Three major therapies have been targeted to improve intellectual disability (ID) in Down syndrome (DS): green tea extracts containing epigallocatechin-3-gallate (EGCG), other antioxidants and fluoxetine. EGCG, the only studied in humans, has shown beneficial effects in visual memory recognition, spatial working memory and executive functions. Its use can be considered if the recommended dose and careful monitoring are respected. The benefits of other antioxidants are controversial. Fluoxetine trials in mice models, either prenatal or postnatal, are promising. Conclusions: There is still not enough scientific evidence to recommend, without reservations, any pharmacological therapy to improve ID in DS. The adverse effects associated with some of these emerging therapies underline the need for proper counselling of the caregivers by medical providers. KEYWORDS down syndrome, intellectual disability, trisomy 21.