Stuttering treated with olanzapine: a case report.

INTRODUCTION: Spasmophemia, also called stuttering or stammering, is a speech disorder characterized by impairment of the rhythm of words whose classical symptoms are blocks and repetitions. METHODOLOGY: We describe the case of a male patient, his evolution and therapeutic strategies and review the current literature on the subject. RESULTS: A 33-year-old patient was referred to our Mental Health Unit by his family doctor due to "speech problems and difficulty expressing ideas. His symptoms had worsened in recent weeks, with increase in his state of anxiety." Standing out in the consultation to the doctor, the patient experienced multiple blocks in expressing words, using circumlocutions and monosyllabic repetitions that made it very difficult to conduct the interview. Anticipatory anxiety and occasional obsessions of repeated checking also stand out. After six weeks of treatment with olanzapine 5 mg/daily, the patient showed significant improvement both in the fluency and anticipatory anxiety with decreased repetitions, blocking, interjections and broken words. DISCUSSION: Spasmophemia has been associated with dopaminergic hyperactivity, so that studies have been conducted with atypical antipsychotics. Fundamentally, olanzapine and risperidone have revealed promising results. Furthermore, several studies have shown that these patients have higher rates of anxiety. That is why antidepressants and antianxiety drugs such as clomipramine, paroxetine, fluoxetine, citalopram, sertraline and alprazolam have been used. CONCLUSION: Treatment with olanzapine, 5HT-2 and D1/ D2 antagonist, significantly improved the clinical picture as Boyd et al. have described in their systematic review.

A propósito de un caso de espasmofemia tratado con olanzapina / Stuttering treated with olanzapine: a case report

Introducción. La espasmofemia, también llamada disfemia o tartamudeo, es un trastorno del habla caracterizado por la alteración del ritmo de las palabras y cuyos síntomas clásicos son los bloqueos y las repeticiones. Metodología. Se describe el caso clínico de un paciente, su evolución y estrategias terapéuticas, asimismo se revisa la literatura actual acerca del tema. Resultados. Paciente de 33 años, derivado a nuestra Unidad de Salud Mental por su médico de cabecera al presentar: "problemas de expresión y dificultad para expresar ideas, clínica que ha empeorado en las últimas semanas incrementándose su estado de angustia". En consulta destacan múltiples bloqueos en la emisión del lenguaje con circunloquios y repeticiones monosilábicas que plantean grandes dificultades para realizar la entrevista. Destaca también ansiedad anticipatoria y ocasionales obsesiones de comprobación. Tras seis semanas de tratamiento con olanzapina 5 mg/ día, presenta una mejoría significativa tanto en la fluidez, como en la ansiedad anticipatoria con disminución de las repeticiones, bloqueos, interjecciones y palabras entrecortadas. Discusión. La espasmofemia se ha asociado con una hiperactividad dopaminérgica por lo que se han realizado estudios con antipsicóticos atípicos: fundamentalmente olanzapina y risperidona, que han desvelado resultados prometedores. Por otra parte diversos estudios constatan que estos pacientes presentan índices más altos de ansiedad. Para ello se han empleado fármacos antidepresivos y ansiolíticos como la clomipramina, paroxetina, fluoxetina, citalopram, sertralina y alprazolam. Conclusión. El tratamiento con olanzapina, antagonista de los receptores 5HT-2 y D1/D2, mejoró significativamente el cuadro clínico tal como han descrito Boyd y cols. en su revisión sistemática (AU)

Introduction. Spasmophemia, also called stuttering or stammering, is a speech disorder characterized by impairment of the rhythm of words whose classical symptoms are blocks and repetitions. Methodology. We describe the case of a male patient, his evolution and therapeutic strategies and review the current literature on the subject. Results. A 33-year-old patient was referred to our Mental Health Unit by his family doctor due to "speech problems and difficulty expressing ideas. His symptoms had worsened in recent weeks, with increase in his state of anxiety". Standing out in the consultation to the doctor, the patient experienced multiple blocks in expressing words, using circumlocutions and monosyllabic repetitions that made it very difficult to conduct the interview. Anticipatory anxiety and occasional obsessions of repeated checking also stand out. After six weeks of treatment with olanzapine 5mg/ daily, the patient showed significant improvement both in the fluency and anticipatory anxiety with decreased repetitions, blocking, interjections and broken words. Discussion. Spasmophemia has been associated with dopaminergic hyperactivity, so that studies have been conducted with atypical antipsychotics. Fundamentally, olanzapine and risperidone have revealed promising results. Furthermore, several studies have shown that these patients have higher rates of anxiety. That is why antidepressants and antianxiety drugs such as clomipramine, paroxetine, fluoxetine, citalopram, sertraline and alprazolam have been used. Conclusion. Treatment with olanzapine, 5HT-2 and D1/D2 antagonist, significantly improved the clinical picture as Boyd et al. have described in their systematic review (AU)