Acquired multiple acyl-CoA dehydrogenase deficiency (MADD) provoked by sertraline: an emerging and treatable disorder

Multiple acyl-CoA dehydrogenase deficiency (MADD), also known as glutaric aciduria type II, is a disorder of mitochondrial fatty acid and amino acid oxidation caused by impaired electron transfer flavoprotein-dependent β-oxidation. Late-onset MADD typically presents in adolescence or adulthood with subacute or progressive proximal muscle weakness, exercise intolerance and lipid storage myopathy, and often responds to riboflavin supplementation.1–3 In recent years, clinicians are increasingly recognising an acquired, drug-associated MADD-like phenotype, particularly associated with sertraline use.3–6