As a 62-year-old grandmother who has dealt with a severe stutter all her life, Sue Payne was skeptical when a friend told her last year about a study of a new drug that might relieve her speech problem.
“I just laughed when I heard about it,” said Payne, a special-education counselor from Austin, Texas, who laughs at the memory even now. “I thought, `Gee whiz, I’d like to try that just to see what it’s like.'”
But six months of taking two experimental pills each morning made a believer of Payne, who said she speaks with fewer staccato pauses between words than before. Her improvement has come as many experts are taking the promise of medication for stuttering more seriously.
Treatments for stuttering still lag behind scientists’ changing understanding of the disorder, which affects about 3 million Americans. Since the 1950s, when Freudian therapists blamed the problem on overbearing parents, researchers have recognized the role of biological factors such as genetics and the development of language centers in the brain.
Still, until recently, scientists struggled to find drugs to attack the disorder at its biological roots. Dr. Gerald Maguire, a psychiatrist and stuttering specialist at the University of California at Irvine, said his studies over the last decade on drugs for stuttering ran into resistance within his own field.
“When we started this research, it was kind of heretical to suggest there was something wrong with the brains of people who stutter,” Maguire said.
In the 1990s researchers identified the first medications that seemed to improve some stuttering symptoms. Drugs such as risperidone and olanzapine, first developed to treat schizophrenia, work by blocking activity of the chemical messenger dopamine, which may be elevated for schizophrenics and people who stutter.
One beneficiary of olanzapine is Maguire, who has stuttered as long as he can remember.
Maguire said he learned at an early age to be a class clown, because his disorder seemed to disappear when he imitated the voices of cartoon characters such as Donald Duck or Elmer Fudd. He said taking the anti-psychotic drugs that came into use in the 1990s made his speech feel natural for the first time.
“I lived every single waking moment thinking about my speech and monitoring my speech,” Maguire said. “Now the words just come out.”
Maguire is helping conduct a study of a new compound called pagoclone, the drug that Payne credits with improving her speech. Although the medication’s precise mode of action is unclear, scientists know it inhibits a neurotransmitter called GABA, quieting the cacophony of brain signals thought to play a role in stuttering.
The drug’s maker, Massachusetts-based Indevus Pharmaceuticals Inc., says its study found that more than half of 88 adult patients who received the drug showed improvement in their speech after two months. The results are preliminary and have not yet been published in a peer-reviewed journal.
Experts say none of the drugs under study will cure stuttering. Many patients still may benefit most from traditional behavioral therapy, said Kristin Chmela, a speech pathologist based in Long Grove.
One promising new technique called the Lidcombe program involves training parents to give their young children constructive feedback on their speech. A study published last year in the British Medical Journal found that preschool children on the program reduced their stuttering by 77 percent after nine months.
“For many people, medication may be the right choice,” Chmela said. “But if you have a child with a mild problem, that may not be the right choice. As we advance in research, we should get more and more options.”
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jmanier@tribune.com
