ABSTRACT
Amyotrophic lateral sclerosis (ALS) is a rapidly progressive neurodegeneration involving motor neurons. The 3-5 years that patients have to live is marked by day-to-day loss of motor and sometimes cognitive abilities. Enormous amounts of healthcare services and resources are necessary to support patients and their caregivers during this relatively short but burdensome journey. Organization and management of these resources need to best meet patients' expectations and health system efficiency mandates. This can only occur in the setting of multidisciplinary ALS clinics which are known as the gold standard of ALS care worldwide. To introduce this standard to the care of Iranian ALS patients, which is an inevitable quality milestone, a national ALS clinical practice guideline is the necessary first step. The National ALS guideline will serve as the knowledge base for the development of local clinical pathways to guide patient journeys in multidisciplinary ALS clinics. To this end, we gathered a team of national neuromuscular experts as well as experts in related specialties necessary for delivering multidisciplinary care to ALS patients to develop the Iranian ALS clinical practice guideline. Clinical questions were prepared in the Patient, Intervention, Comparison, and Outcome (PICO) format to serve as a guide for the literature search. Considering the lack of adequate national/local studies at this time, a consensus-based approach was taken to evaluate the quality of the retrieved evidence and summarize recommendations.
ABSTRACT
BACKGROUND: The aim of this study was to compare the effects of olanzapine versus haloperidol to control the signs and symptoms of stuttering. METHODS: Ninety-three patients were recruited in a 12-week single-blind randomized clinical trial, which was held between October 2009 and October 2010. Forty-three patients received olanzapine (5 mg/day) and 50 patients, haloperidol (2.5 mg/day). Before and after the study, they were evaluated by a speech pathologist by Van Riper's questionnaire. The data were analyzed using the SPSS version 16. T-test was used to compare the data between the two groups. RESULTS: Mean of stuttering score (SD) before treatment was 4.67 (0.81) and 4.40 (1.14) in haloperidol and olanzapine groups, respectively (P > 0.05). After treatment, the mean (SD) score was 2.87 (1.32) and 1.56 (0.71) in haloperidol and olanzapine groups, respectively (P = 0.000). CONCLUSIONS: It seems that olanzapine does have better impact in controlling stuttering, and it may be recommended to prescribe olanzapine for stutters as the first choice to control the stuttering under a careful follow-up.
