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FAU helping the flow of words with drug trial for stuttering

What do Marilyn Monroe, Joe Biden and Tiger Woods have in common? Stuttering. All of them have suffered through interrupted speech patterns caused by prolonged sounds, word repetitions and unintended pauses.

In the coming months, researchers at Florida Atlantic University will conduct a drug trial on the first pharmacological intervention for stuttering, featured on CNN and ABC’s "20/20."

If successful, this upcoming trial may support Pagoclone becoming the speech intervention of choice for more than three million Americans who struggle with stuttering.

In an earlier study of Pagoclone, conducted by Dr. Gerald A. Maguire at the University of California, Irvine, more than 50 percent of participants experienced greater speech fluency with reduced social anxiety.

The primary investigator of FAU’s Pagoclone trial knows all too well the frustrations caused by stuttering. Psychiatrist Peter Holland of Boca Raton is part of the 1 percent of the population that deals with the difficulties of stuttering.

“I have stuttered all my life,” Holland said, “and it has made me work four times as hard. I can’t emphasize enough how landmark this study is.”

Holland said that anti-anxiety medications such as Xanax and Celexa are sometimes prescribed for stuttering “off label.” This means that the drugs being prescribed are not designed, tested or approved by the FDA for the treatment of stuttering.

Holland’s research may help Pagoclone become the only approved drug on the market specifically for stuttering. In addition to showing positive results for speech fluency in earlier trials, Pagoclone has fewer side effects than commonly prescribed anti-anxiety medications.

“Pagoclone was found to be well-tolerated with only minor side-effects of headache and fatigue reported in a minority of those treated,” wrote Maguire in a 2007 newsletter from the Stuttering Foundation.

Four times as many males as females stutter. The causes of are linked to genetics, brain activity, childhood development and family dynamics. The oldest speech disorder on record, stuttering is triggered by the presence of other people.

“As a rule, a person who stutters is 100 percent fluent if they are speaking without anyone else in the room,” Holland said.

Yet the presence of another person can halt stuttering. If the person who stutters speaks in unison with a fluent speaker they will also speak fluidly – a phenomenon called the choral effect.

One intervention capitalizes on this phenomenon by playing back a time-delayed recording of a person’s voice with a pitch change so it sounds like they are speaking in unison with another person. Unfortunately, benefits from this device are temporary as the brain eventually adapts and reverts back to stuttering.

Other interventions include speech therapy for the slowing of speech and increasing one’s concentration on the formation of word sounds. This proves somewhat helpful but does not eliminate stuttering in adults.

“We are learning that stuttering is actually a miscommunication of the brain speech centers with the mouth, tongue and throat for getting the words out,” Maguire said.

Pagoclone is a dopamine blocker that aids communication in the brains of people who stutter. Its alteration of brain chemistry helps reduce excessive brain activity, according to Endo, the pharmaceutical firm that holds the drug’s patent through its recent acquisition of Indevus Pharmaceuticals.

To help bring this drug closer to market, Holland will work on this double-blind, placebo-controlled study in collaboration with the director of the Fluency Clinic at FAU, speech pathologist Dale Williams, associate professor in the department of Communication Sciences and Disorders. He is also co-facilitator of the Support Group for Persons Who Stutter, and author of Stuttering Recovery: Personal and Empirical Perspectives.

Williams will do the frequency testing as participants are tested at various periods throughout the trial. The frequency tests look for incidences of stuttering and calculate percentages. These will determine the drugs effectiveness.

Although Williams is hopeful this drug will prove beneficial, he doubts it will be the magic bullet people who stutter, and those who care about them, have been hoping for.

“This is not likely to be a universal cure that will put speech pathologists out of business,” Williams said. “But hopefully it will help a number of people.”

Holland and Williams have enrolled English-speaking participants between the ages of 18 and 80 who began stuttering before age 8, and have a minimum eighth-grade education.

Those participating are receiving study-related medical care and study medication at no cost. Contact Tracey Thomas at 561-297-0164 or tracey.thomas@fau.edu for more information.




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FAU helping the flow of words with drug trial for stuttering