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Zebrowski, Patricia M. et al.: 2022 Stuttering and Related Disorders of Fluency DOI: 10.1055/b-0042-189426
Section V Additional Treatment Considerations

15 Pharmacological Considerations for the Treatment of Stuttering

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Book

Editors: Zebrowski, Patricia M.; Anderson, Julie D.; Conture, Edward G.

Authors: Ames, Angharad; Arnold, Hayley S.; Beal, Deryk; Beilby, Janet; Below, Jennifer E.; Byrd, Courtney; Choi, Dahye; Coleman, Craig; DiLollo, Anthony; Eggers, Kurt; Fortier-Blanc, Julie; Franken, Marie-Christine; Garbarino, Julianne; Gerlach-Houck, Hope; Gillis, Corrin I.; Hall, Nancy E.; Hearne, Anna; Herring, Caryn; Jackson, Eric S.; Johnson, Kia Noelle; Jones, Robin; Kelly, Ellen M.; Kraft, Shelly Jo; LaSalle, Lisa; Logan, Kenneth J.; Maguire, Gerald; Millard, Sharon; Nil, Luc F. De; Ntourou, Katerina; Ratner, Nan Bernstein; Reichel, Isabella; Rodgers, Naomi; Scott, Kathleen Scaler; Singer, Cara M.; Sønsterud, Hilda; Tendera, Anna; Theys, Catherine; Tumanova, Victoria; Usler, Evan; Wagovich, Stacy; Yaruss, J. Scott; Zengin-Bolatkale, Hatun

Title: Stuttering and Related Disorders of Fluency

Print ISBN: 9781684202539; Online ISBN: 9781684202638; Book DOI: 10.1055/b000000273

4. Edition © 2022. Thieme. All rights reserved.
Thieme Medical Publishers, Inc., New York

Subjects: Otorhinolaryngology, Phoniatrics, Audiology

Thieme Clinical Collections (English Language)



 
Lisa LaSalle, Angharad Ames, and Gerald Maguire

Abstract

Pharmacological considerations for adults who stutter are important for an interprofessional team to address. This chapter provides information that speech-language pathologists need to know about pharmacotherapy for adults who stutter. We begin with a dopamine hypothesis about stuttering—how persistent developmental stuttering is likely a hyperdopaminergic condition similar to Tourette’s syndrome. Background is provided as to how neurotransmitter reuptake, the placebo effect, and safety play a role in medication development. A historical perspective is then added, spanning the earlier use of haloperidol to the present use of newer, second-generation dopamine antagonists. New investigatory medications such as ecopipam are included. Second-generation dopamine antagonists currently used to treat stuttering with the lowest adverse drug reaction profiles include six medications (e.g., asenapine), presented in a table format. Adverse drug reactions are also considered, as they occur with all medications, but can be minimized with careful dosage decisions. Stuttering, for the purpose of this chapter, will include (1) persistent developmental stuttering, whether comorbid/co-occurring or not; (2) exacerbated stuttering (i.e., paradoxical effects); and (3) acquired stuttering (i.e., iatrogenic effects) versus serendipitous stuttering amelioration that may occur when individuals who stutter are medicated for a co-occurring condition. We then discuss the effect of medications prescribed for other conditions on both persistent developmental stuttering and acquired stuttering. Future directions include new medications, and combining support/self-help group, behavioral treatment, and/or pharmacotherapy is recommended. Treatment options arise from the informed client’s wishes in both an evidence-based practice and a cost–benefit type framework. Finally, we believe that pharmacological considerations for adults who stutter are where our ethics, counseling, scope of practice, and interprofessional practice intersect to provide the best possible treatment options.

Key words

persistent developmental stuttering - medication - dopamine - hyperdopaminergic condition - dopamine antagonists - pharmacotherapy - interprofessional practice - speech-language pathologists and psychiatrists - comorbidity - necessity–concerns framework
 
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