Emergence of Stuttering in An Attention Deficit Hyperactivity Disorder Patient Treated With Methylphenidate

Dusunen Adam The Journal of Psychiatry and Neurological Sciences 2018;31:222-224 Letter to the Editor / Editöre Mektup
DOI: 10.5350/DAJPN2018310212
Emergence of Stuttering in Mazlum Copur1 , Sidar Copur2
an Attention Deficit 1Istanbul

Arel University, Faculty of Arts and Sciences,
Department of Psychology, Istanbul - Turkey
2Koc University, Faculty of Medicine, Istanbul - Turkey
Hyperactivity Disorder
Patient Treated with
Methylphenidate
How to cite this article: Copur M, Copur S. Emergence of stuttering in an attention deficit hyperactivity disorder patient treated with methylphenidate. Dusunen
Adam The Journal of Psychiatry and Neurological Sciences 2018;31:222-224. https://doi.org/10.5350/DAJPN2018310212
Address reprint requests to / Yazışma adresi: Sidar Copur, Zuhtupasa Mah., Fahrettin Kerim Gokay Cad., No.46, A-2 Blok D.52, Kadikoy/Istanbul, Turkey
Phone / Telefon: +90-212-543-7016
E-mail address / Elektronik posta adresi: sidar1996@yahoo.com.tr
Date of receipt / Geliş tarihi: August 22, 2017 / 22 Ağustos 2017
Date of the first revision letter / İlk düzeltme öneri tarihi: September 29, 2017 / 29 Eylül 2017
Date of acceptance / Kabul tarihi: November 12, 2017 / 12 Kasım 2017
Dear Editor, most common type of stuttering, developmental

stuttering, the exact etiology of which is unknown,
According to Diagnostic and Statistical Manual of arises early in childhood. Possible causes of
Mental Disorders Fifth Edition (DSM-5), there are developmental stuttering include genetic, linguistic,
certain criteria that must be met in order for the diagnosis motor and neuronal factors. On the other hand,
of childhood-onset fluency disorder to be made: sound reasons of neurogenic stuttering are degenerative
and syllable repetitions, sound prolongations, central nervous system (CNS) diseases, brain tumors
interjections, audible or silent blocking, circumlocutions, and traumatic brain injury, utilization of drugs,
broken words, words formed with an overload of dialysis, and dementia (3).
physical tension, or word repetitions (1). Emergence of A.D., a seven-year-old male student in a primary
stuttering typically occurs between ages 2 and 7 (90% of school, was diagnosed with Attention Deficit
the cases), and 65-80% of stuttering cases resolve Hyperactivity Disorder (ADHD), according to the
spontaneously. Stuttering is a multifactorial disorder in Diagnostic Criteria of DSM-5. He was prescribed short
which genetic, neurophysiological, psychological and acting methylphenidate 5mg in the morning and 5mg
environmental factors have an influence (2). at noon. Stuttering arose on the next day the patient
Stuttering can be divided into 3 categories started taking the medication. Troubles during the
depending on the reasons of its emergence: pronunciation of the first syllables and repetitions of
developmental, neurogenic, and psychological. The some syllables were observed. After taking the
222 Dusunen Adam The Journal of Psychiatry and Neurological Sciences, Volume 31, Number 2, June 2018
Copur M, Copur S
medication for 10 days, his parents and teachers stated methylphenidate is suitable for treating the
that attention and hyperactivity symptoms were condition (3). Similar results were established by two
significantly improved; however, the patient was case reports indicating improvement in stuttering
suffering from stuttering for a roughly 2-hour period symptoms when treated with methylphenidate
following the medication intake. After this period, (11- and 18-year-old patients) (4,5).
stuttering symptoms diminished noticeably. Therefore, On the other hand, worsening of stuttering in
methylphenidate treatment was terminated. However, patients suffering from developmental stuttering when
methylphenidate treatment, 10mg in the morning and treated with dopamine agonists such as levodopa and
5mg at noon, was reinstated after a break of 10 days detection of a significant increase in cerebral dopamine
due to his parents’ and teachers’ observations regarding levels in stutterers indicate the possibility of an
a worsening in the symptoms of hyperactivity and lack emergence of stuttering in patients treated with
of attention compared to the pre-medication period. methylphenidate (6,7). There are two studies focusing
The patient started to suffer from stuttering on the on this topic: a case reporting the emergence of
same day. Ten days later, his parents reaffirmed that stuttering in a 7-year-old patient when treated with
the patient mostly suffered from stuttering during a short acting methylphenidate and another study
2-hour period after medication intake, while the reporting the occurrence of stuttering in a 3-year-old
symptom of stuttering became imperceptible after that patient diagnosed with ADHD when treated with
period. In addition, obvious stuttering symptoms were pemolin and methylphenidate (4,8).
observed during clinical examination of the patient The fact that methylphenidate has contradictory
after he had used the medication with the prescribed influences on stuttering in different cases demonstrates
dosage. According to the diagnostic criteria of DSM-5, that stuttering develops by different mechanisms in
the childhood onset fluency disorder (stuttering) that each case, which can alter the outcomes of
the patient was suffering from is classified as methylphenidate treatment.
neurogenic-type stuttering. Methylphenidate treatment Recent studies demonstrate a higher prevalence of
was stopped after 4 months when the patient started to stuttering in ADHD patients compared to the general
suffer from stuttering all day long. Symptoms of population (6,7,9). These findings indicate that the
stuttering completely disappeared after 10 days and no co-existence of ADHD and stuttering should not be
relapse was recorded in the examinations performed overlooked. The case we are presenting is significant
every 2 months throughout the following 6 months. for being one of the few studies revealing an
In the literature review conducted regarding the exacerbation of stuttering. Contradictory outcomes
association between methylphenidate and from different studies about the association of
stuttering, we found a study testing methylphenidate methylphenidate and stuttering demonstrate the need
as a treatment option for stuttering, suggesting that for further comprehensive research in this field.
REFERENCES
1. American Psychiatric Association. Diagnostic and statistical 4. Devroey D, Beerens G, Van De Vijver E. Methylphenidate as a
manual of mental disorders. Fifth Ed. Washington, DC: American treatment for stuttering: a case report. Eur Rev Med Pharmacol
Psychiatric Publishing, 2013. Sci 2012; 16(Suppl.4):66-69.
2. Sadock BJ, Sadock VA, Ruiz P. Kaplan and Sadock’s synopsis of 5. Bozatli L, Berberoglu KK, Ceylan C, Gorker I. Improvement
psychiatry, behavioral sciences/clinical psychiatry. Eleventh Ed. of stuttering with use of methylphenidate in a child who was
Philadelphia: Wolters Kluwer, 2015. diagnosed with concomitant stuttering and ADHD. Anatolian
Journal of Psychiatry 2016; 17(Suppl.3):71-73. (Turkish)
3. Sathya JMA, Victor SP. Types and tools available for fluency [CrossRef]
disorder - speech therapy. International Journal of Engineering
and Computer Science 2015; 4:12423-12428.
Dusunen Adam The Journal of Psychiatry and Neurological Sciences, Volume 31, Number 2, June 2018 223
Emergence of stuttering in an attention deficit hyperactivity disorder patient treated with methylphenidate
6. Anderson JM, Hughes JD, Rothi LJ, Crucian GP, Heilman KM. 8. Alpaslan AH, Coskun KS, Kocak U, Gorucu Y. Stuttering
Developmental stuttering and Parkinson’s disease: the effects associated with the use of short-acting oral methylphenidate. J
of levodopa treatment. J Neurol Neurosurg Psychiatry 1999; Clin Psychopharmacol 2015; 35:739-741. (Turkish) [CrossRef]
66:776-778. [CrossRef]
9. Blood GW, Ridenour VJ, Qualls CD, Hammer CS. Co-occurring
7. Wu JC, Maguire G, Riley G, Lee A, Keator D, Tang C, Fallon J, disorders in children who stutter. J Commun Disord 2003;
Najafi A. Increased dopamine activity associated with stuttering. 36:427-448. [CrossRef]
Neuroreport 1997; 8:767–770. [CrossRef]
224 Dusunen Adam The Journal of Psychiatry and Neurological Sciences, Volume 31, Number 2, June 2018

Emergence of Stuttering in An Attention Deficit Hyperactivity Disorder Patient Treated With Methylphenidate

Uploaded by

Copyright:

Available Formats

Emergence of Stuttering in An Attention Deficit Hyperactivity Disorder Patient Treated With Methylphenidate

Uploaded by

Document Information

Original Description:

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Emergence of Stuttering in An Attention Deficit Hyperactivity Disorder Patient Treated With Methylphenidate

Uploaded by

Copyright:

Available Formats

Dusunen Adam The Journal of Psychiatry and Neurological Sciences 2018;31:222-224 Letter to the Editor / Editöre Mektup

Emergence of Stuttering in Mazlum Copur1 , Sidar Copur2

an Attention Deficit 1Istanbul

Dear Editor, most common type of stuttering, developmental

You might also like

Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.