Ömer ASAN, Elif TATLIDİL, Elif TATLIDİL YAYLACI, Erol GÖKA

A Case of Stuttering Due to Olanzapine Treatment

Stuttering is defined as a disturbance in time patterning and fluency of speech inappropriate for an individual’s age. The pathophysiology of stuttering is not fully understood. Some studies show that stuttering is related with an increased number of D2 receptors in the basal ganglia. Otherwise, a 50-200% increase in the level of dopaminergic activity has been found in stuttering cases in comparison to the control group. Stuttering as a side-effect of psychotropic medication is rare. Only a few stuttering cases are reported in the literature as being due to effects of antipsychotics like chlorpromazine, clozapine, olanzapine, risperidone, or trifluoperazine. Olanzapine is also used to treat the symptoms of stuttering via D2 receptor antagonism, and in the literature there are cases treated with the administration of olanzapine. Here we present a case of olanzapine-induced stuttering. The importance of this case is to show that while olanzapine may be used in the treatment of stuttering, it may also be the cause of stuttering as an adverse effect.

Olanzapin kullanımına bağlı gelişen bir kekemelik olgusu

Kekemelik; yaşla uyumsuz olarak konuşmanın akıcılığı ve zamanlamasındaki bozukluk olarak tanımlanır. Etiyolojisi halen tam olarak bilinmemektedir. Yayınlanmış bazı çalışmalar kekemeliğin bazal gangliyonlarda artmış D2 reseptör seviyesiyle ilişkili olduğunu göstermiştir. Ayrıca kekemelik olgularında kontrol grubuna göre %50-200 oranında artmış dopaminerjik aktivite saptanmıştır. Kekemelik nadiren psikotropik ilaçların yan etkisi olarak ortaya çıkmaktadır. Literatürde az sayıda klorpromazin, klozapin, olanzapin, risperidon ve trifluperazin kullanımına bağlı gelişmiş kekemelik olguları mevcuttur. Aynı zamanda olanzapinin D2 reseptör antagonizması yaparak kekemelik semptomlarını düzelttiğini belirten olgular da yayınlanmıştır. Bu olgu sunumunda olanzapin kullanımına bağlı gelişen bir kekemelik olgusu sunduk. Bu olgu olanzapinin kekemelik semptomlarının tedavisinde kullanılmasının yanı sıra, bir yan etki olarak kekemeliğe yol açabildiğini göstermesi açısından önemlidir.

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Maguire GA, Yeh CY, Ito BS. Overview of the diagnosis and treatment of stuttering. J Exp Clin Med 2012; 4:92-97. [CrossRef]

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders Fourth Ed., Text Revision. Washington, DC; 2000.

Guitar BE. Stuttering and stammering. Pediatr Rev 1985; 7:163- 168. [CrossRef]

Maguire G. Without Hesitation: Speaking to the Silence and the Science of Stuttering. New York, NY: National Stuttering Association, 2010.

Andrews G, Craig A, Feyer A, Hoddinott S, Howie P, Neilson M. Stuttering: a review of research findings and theories circa 1982. J Speech Hear Disord 1983; 48:226-246. [CrossRef]

Aras S. Communication Disorders: In Gulec C, Koroglu E (editors). Foundations of Psychiatry. Second ed., Ankara: Physicians’ Publishing Union, 2007, 777-797. (Turkish)

Ashurst JV, Wasson MN. Developmental and persistent developmental stuttering: an overview for primary care physicians. J Am Osteopath Assoc 2011; 111:576-580.

Belgin E, Derinsu U. Incidence of speech and voice disorders in primary school children. 19. National Turkish Congress of Otorhinolaryngology. Istanbul, 1990, 158-160. (Turkish)

Bloodstein O. A Handbook on Stuttering, Fifth Ed., San Diego: Singular Publishing Group, 1995.

Blood GW. Laterality differences in child stutterers: heterogeneity, severity levels, and statistical treatments. J Speech Hear Disord 1985; 50:66-72. [CrossRef]

Wu JC, Maguire G, Riley G, Lee A, Keator D, Tang C, Fallon J, Najafi A. Increased dopamine activity associated with stuttering. Neuroreport 1997; 8:767-770. [CrossRef]

Wu JC, Maguire G, Riley G, Fallon J, LaCasse L, Chin S, Klein E, Tang C, Cadwell S, Lottenberg S. A positron emission tomography [18F] deoxyglucose study of developmental stuttering. Neuroreport 1995; 6:501-505. [CrossRef]

Anderson JM, Hughes JD, Rothi LJ, Crucian GP, Heilman KM. Developmental stuttering and Parkinson’s disease: the effects of levodopa treatment. J Neurol Neurosurg Psychiatry 1999; 66:776-778. [CrossRef]

Rosenberger PB, Wheelden JA, Kalotkin M. The effect of haloperidol on stuttering. Am J Psychiatry 1976; 133:331-334. [CrossRef]

Rothenberger A, Johannsen HS, Schulze H, Amorosa H, Rommel D. Use of tiapride on stuttering in children and adolescents. Percept Mot Skills 1994; 79:1163-1170.

Maguire G, Riley GD, Franklin DL, Gottschalk LA. Risperidone for the treatment of stuttering. J Clin Psychopharmacol 2000; 20:479-482. [CrossRef]

Maguire GA, Riley G, Franklin DL, Maguire ME, Nguyen CT, Brojeni PH. Olanzapine in the treatment of developmental stuttering: a double-blind, placebo-controlled trial. Ann Clin Psychiatry 2004; 16:63-67. [CrossRef]

Brady JP, McAllister TW, Price TR. Verapamil in stuttering. Biol Psychiatry 1990; 27:680-681. [CrossRef]

Maguire G, Riley G, Hahn R, Plon L. Nimodipine in the treatment of stuttering. ASHA J 1994;36:51.

Brady JP. The pharmacology of stuttering: a critical review. Am J Psychiatry 1991; 148:1309-1316. [CrossRef]

Stager S, Calis K, Grothe D, Bloch M, Turcasso N, Ludlow C, Braun A. A double blind trial of pimozide and paroxetine for stuttering: In Hulstijn W, Peters HFM, Van Lieshout PHHM (editors). Speech Production: Motor Control, Brain Research and Fluency Disorders. Amsterdam: Elsevier, 1997, 379-382.

Yannatos G, L’hydroxyzine dans la therapeutique des begaiements. J Fr Otorhinolaryngol Chir Maxillofac 1960; 9:293-296.

Kumar A, Balan S. Fluoxetine for persistent developmental stuttering. Clin Neuropharmacol 2007; 30:58-59. [CrossRef]23. Kumar A, Balan S. Fluoxetine for persistent developmental stuttering. Clin Neuropharmacol 2007; 30:58-59. [CrossRef]

Atay IM, Tanritanir B, Akpinar A, Demirdas A. A Case of Risperidone Induced Stuttering as a Paradox. Case Report. Noro Psikiyatr Ars 2014; 51:403-404. [CrossRef] (Turkish)

Yadav DS. Risperidone induced stuttering. Gen Hosp Psychiatry 2010; 32:559.e9-10. [CrossRef]

Bar KJ, Hager F, Sauer H. Olanzapine and clozapine induced stuttering. A case series. Pharmacopsychiatry 2004; 37:131-134. [CrossRef]

Thomas P, Lalaux N, Vaiva G, Goudemand M. Dose-dependent stuttering and dystonia in a patient taking clozapine. Am J Psychiatry 1994; 151:1096. [CrossRef]

Vossler DG, Haltiner AM, Schepp SK, Friel PA, Caylor LM, Morgan JD, Doherty MJ. Ictal stuttering: a sign suggestive of psychogenic nonepileptic seizures. Neurology 2004; 63:516-519. [CrossRef]

Gulec G, Rukiye YK. Seizure associated with olanzapine: case report. Bulletin of Clinical Psychopharmacology 2007; 17:134- 137. (Turkish)