A Case Report of Stuttering Induced by Risperidone and Chlorpromazine.

Stuttering, a disturbance in the normal fluency and time patterning of speech is usually developmental. In some cases, it is acquired, and causes include stroke, brain tumor, and trauma. Implicated in the causation of stuttering are overactive presynaptic dopamine systems in the region of the brain that modulate verbalization. It is a rare side effect of antipsychotic medications and has been reported with phenothiazines, clozapine, and risperidone. This is a report of a patient who developed stuttering when treated first with chlorpromazine and later with risperidone. Patient had a diagnosis of schizoaffective disorder and had been treated with antipsychotic medications including haloperidol, olanzapine, and paliperidone. He developed stuttering for the first time upon receiving intramuscular injections of chlorpromazine for treatment of agitation. The stutter improved and eventually resolved. He subsequently presented with a severe stutter when he was treated with risperidone. The stutter improved after risperidone was discontinued. It is speculated that drug-induced stuttering may be a manifestation of akathisia leading to noradrenergic and serotonergic mechanisms being implicated. It could be that either the cholinergic, dopaminergic or serotonergic systems are involved or that there is an imbalance of these systems that may be relevant.

Clozapine-induced stuttering in the absence of known risk factors: a case report.

BACKGROUND: Stuttering is a rare side effect of clozapine. It has been shown to occur in the presence of one or more factors such as abnormal electrophysiological findings and seizures, extrapyramidal symptoms, brain pathology, and a family history of stuttering. Few case reports have documented the occurrence of clozapine-induced stuttering in the absence of these risk factors. CASE PRESENTATION: A 29-year-old African male on clozapine for treatment-resistant schizophrenia presented with stuttering at a dosage of 400 mg/day that resolved with dose reduction. Electroencephalogram findings were normal, and there was no clinical evidence of seizures. The patient had no prior history or family history of stuttering, had a normal neurological examination, and showed no signs of extrapyramidal symptoms. CONCLUSION: Clinicians ought to be aware of stuttering as a side effect of clozapine, even in the absence of known risk factors. Further research should investigate the pathophysiology of clozapine-induced stuttering.

Drug induced stuttering: pharmacovigilance data.

Background: Stuttering is a speech disorder characterized by poor fluency of speech despite the speech production organs being normal. Numerous factors contribute to stuttering, and it may also be an iatrogenic effect of certain drugs. The aim of this study was to investigate the association between stuttering and drug exposure.Research design and methods: We investigated the association between drugs and stuttering. We analyzed reports in the World Health Organization global individual case safety reports database (Vigibase) up to 31 May 2020 with the MedDRA lower level terms 'stutter' and 'stuttering.' The association between a drug and the occurrence of the adverse drug reaction was estimated by disproportionality analysis. Reporting odds ratios (ROR) were calculated with 95% confidence intervals.Results: In total, 724 notifications were identified using the MedDRA terms selected. The main drugs implicated were methylphenidate (ROR = 19.58; 95% CI: 13.3-28.8), topiramate (ROR = 12.5; 95% CI: 7.1-22.1), olanzapine (ROR = 12; 95% CI: 8-17.9) and golimumab (ROR = 10.2; 95% CI: 5.5-19.1).Conclusions: When stuttering occurs in a patient treated by drugs affecting neurotransmission, a drug-induced origin of the stutter should be considered.

Pregabalin-associated stuttering and frequent blepharospasm: case report and review.

Herpes zoster is an acute, painful, herpes skin disease caused by varicella-zoster virus, which may cause viral meningitis. Pregabalin has been shown to be efficacious in the treatment of pain in patients with herpes zoster. However, it has the side effects of neurotoxicity. We describe a 68-year-old female patient with herpes zoster, and she was treated with pregabalin. The patient presented with stuttering and frequent blepharospasm after 3 days of pregabalin treatment. Pregabalin was discontinued, the symptoms of stuttering and frequent blepharospasm completely resolved without any special treatment after one week. In this case, the etiology of stuttering and frequent blepharospasm may be related to pregabalin. Clinicians should be alert to the rare symptoms associated with the use of pregabalin. Graphical abstract .

Methylphenidate and stuttering.

Methylphenidate (MPH) is a piperidine similar to amphetamines, and is indicated for attention deficit hyperactivity disorder. Studies concerning stuttering occurring with MPH are contradictory. We investigated the association between MPH and stuttering. We analysed reports in the World Health Organization global individual case safety reports database, Vigibase, up to 31 December 2018, with the MedDRA preferred term "dysphemia" and the lower level terms "stutter" and "stuttering". The association between exposure to MPH and occurrence of the adverse drug reaction was estimated by disproportionality analysis. Reporting odds ratios (RORs) were calculated with 95% confidence intervals (CIs). In total, 2975 cases of dysphemia were reported, of which 46 reports were associated with MPH. For the Preferred Term "dysphemia", the ROR was 7.3 (95% CI: 5.4-9.8). With the Lower Level Term "stuttering", 584 cases were registered in the database of which 17 involved MPH. The ROR was 13.9 (95% CI: 8.6-22.5). This study found a signal for stuttering with MPH.

A case of bupropion-induced stuttering.

OBJECTIVE: Stuttering is a frequent side effect of many psychotropic drugs, particularly antidepressants. METHOD: This is a case report of a woman presenting with stuttering after starting bupropion treatment for her depression. RESULTS: The patient's stuttering resolved after discontinuing the bupropion. CONCLUSION: Neuroimaging and pharmacological studies have implicated dopamine in the pathophysiology of stuttering. Bupropion's ability to increase dopamine in the frontal cortex was suspected to have been involved in this patient's stuttering. However, further research is needed before causality can be assured.

A stuttering discovery of lithium toxicity.

An 86-year-old female nursing home resident was typically described by the nursing staff as alert, pleasant, and conversant, although disoriented to time and place at times. She was frequently seen in the hallways, often breaking into song with her melodious voice. Her past medical history was significant for dementia, epilepsy, and bipolar disorder, for which she took lithium carbonate. One day, she complained to her nurse that she had been stuttering, finding it difficult to complete a sentence, as well as sing. This persisted for 3 more months until a lithium level was checked, and came back elevated at 2.0 mmol/L (0.6 to 1.2 mmol/L). Lithium carbonate was promptly stopped and after about 2 weeks, her stuttering had completely resolved. We found considerable interest in this case, as lithium has rarely been associated with drug-induced stuttering. We reviewed drug-induced stuttering, enumerated the medications implicated in various case reports, and discussed its mechanisms and management.

Clozapine-induced stuttering: a case report and analysis of similar case reports in the literature.

There is limited literature reporting clozapine-associated stuttering. In this case report, we present a case of a young male who developed stuttering with clozapine, which improved with dose reduction. Computer-assisted searches on clozapine-induced stuttering yielded 16 cases, and analysis of these case reports suggests that stuttering may be linked to seizures or movement disorders, but other putative mechanisms may be at work, which need further research.

Risperidone induced stuttering.

Stuttering as a side effect of antipsychotics is rare. There are a few case reports of antipsychotic-induced stuttering, namely, chlorpromazine, levomepromazine, trifluoperazine, fluphenazine, olanzapine and clozapine. Risperidone is commonly used as an atypical antipsychotic. It is licensed for both acute and chronic psychosis and mania. There is only one documented case report mentioned on risperidone induced stuttering. One case report of risperidone-induced stuttering is now described. Stuttering is a rare side effect and requires a high index of suspicion for diagnosis. Further study and research to identify the neurophysiological and psychological processes behind adult onset stuttering and identification of the processes involved in risperidone induced stuttering would help our understanding further.

[Acquired stuttering in a psychotic patient]. / Verworven stotteren bij een patiënt met een psychose.

A patient admitted to a psychiatric clinic because of a psychosis, developed a stutter. In this case report we review the literature in order to explain the differential diagnosis of stuttering acquired later in life. In the patient under study we considered the late development of stuttering to be either a side-effect of olanzapine or a symptom of disorganisation. Although the precise cause is still unclear, the patient's stutter decreased considerably after olanzapine was replaced by haloperidol.