Stuttering treated with olanzapine: a case report

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.

We describe the case of a male patient, his evolution and therapeutic strategies and review the current literature on the subject.

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.

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.

Treatment with olanzapine, 5HT-2 and D1/ D2 antagonist, significantly improved the clinical picture as Boyd et al. have described in their systematic review.