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From: Nathan Lavid
Date: 14 Oct 2010
Time: 21:11:10 -0500
Remote Name: 96.229.104.42
Hello Ora, It’s definitely premature to try these medications – all of which are in the same class – without a comprehensive psychiatric/medical evaluation. The reason for my caution is the medications have potential for problems that are morbid. For example, Geodon can prolong the electrical conduction of the heart, which may lead to arrhythmia. This week, I had a patient with severe Tourette disorder who has failed other medications within this class and I offered a trial of Geodon. He has no prior or family history of heart disease and a baseline electrocardiogram (EKG) was normal. After a day on the Geodon, a follow-up EKG revealed prolongation of the electrical conduction of the heart and after a stat consultation with a cardiologist, we ended the trail. I’m providing this example to give you feel for the clinical decisions that are associated with these medications and why, even if they can offer some respite from stuttering, their administration has to be monitored carefully and competently. That said, meeting with a physician to discuss a trial of medication and what type of monitoring is needed of both fluency and possible adverse effects of the medication is reasonable now. An informed, face-to-face evaluation with a physician is only way I could recommend a patient with stuttering consider these medications, as it has to be a personal decision in the context of his or her medical history. As for the stuttering center, I do not know what Gerald and Dave are offering, but I imagine they would be receptive to queries. I hope in five years or so, there will be more options that are less malignant.