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Recent reports of environmental toxins appear to worsen the progression of FXTAS. Here we present a case of male adult with FXTAS and a long history of methadone use. The patient shows a faster progression in both symptoms of disease and MRI changes compared to what is typically seen in FXTAS. There has been no research regarding the role of narcotics in onset, progression, and severity of FXTAS symptoms. However, research has shown that narcotics can have a negative impact on several neurodegenerative diseases, and we hypothesize that in this particular case, methadone may have contributed to a faster progression of FXTAS as well as exacerbating white matter disease through RNA toxicity seen in premutation carriers. \u00a9 2015 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ajmg.a.37030","type":"journal-article","created":{"date-parts":[[2015,4,22]],"date-time":"2015-04-22T03:55:11Z","timestamp":1429674911000},"page":"1354-1359","source":"Crossref","is-referenced-by-count":20,"title":["Methadone use in a male with the <i>FMRI<\/i> premutation and FXTAS"],"prefix":"10.1002","volume":"167","author":[{"given":"Zukhrofi","family":"Muzar","sequence":"first","affiliation":[{"name":"Center for Biomedical Research Faculty of Medicine Diponegoro University Semarang Central Java Indonesia"},{"name":"Medical Investigation of Neurodevelopmental Disorders MIND Institute, University 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