This is a threaded discussion page for the International Stuttering Awareness Day Online Conference paper, A Perspective On Neuropharmacological Agents And Stuttering: Are There Implications For A Cause As Well As A Cure? by Larry Molt (Alabama, USA). Most commonly used drug - Alcohol ;-) From: Gunars K. Neiders, Ph.D. Date: 10/2/98 Time: 9:01:33 PM Remote Name: 22.214.171.124 Comments Dr. Molt, Would you care to discuss the perceived and the probable effect of self administering alcohol? Can any conclusions be drawn about the benefits and advantages? Re: Most commonly used drug - Alcohol ;-) From: Larry Molt Date: 10/7/98 Time: 11:35:16 AM Remote Name: 126.96.36.199 Comments Dear Dr. Neiders: I'm not aware of any empirical research into the perceived vs. probable effects of self administration of ethanol. On the list-serves devoted to stuttering and in conversations, I have heard lots of anectdoctal reports on the effects. My impressions (and these are only impressions, not research) is that a little over half of stuttering individuals report increased fluency when "under the influence", a smaller number report deleterious effects of ethanol, and an even smaller number report their fluency to be unaffected. I've also heard several theories proposed to account for this apparent discrepancy in ethanol's effects. Most commonly, theories suggest that those individuals for whom anxiety in speaking situations plays a role in eliciting stuttering may respond well to the anxyiolytic effects of alcohol, thus experiencing a fluency increase; for those who are able to maintain fluency by exerting additional motoric control strategies, the dyskinethesia associated with ethanol intoxication may disrupt their fluency. In addition, the appearance of a change in fluency (whether positive, neutral, or negative) may be a result of an altered perceptual state rather than an actual change in fluency. As these are only impressions that come from anecdotal reports, I feel that no conclusions can be drawn, especially in light of the discrepancy in results in the neuropharmacological literature between effects reported in open uncontrolled trials vs. those seen in double blind placebo controlled trials. It certainly would be interesting research to conduct, and I'm sure you might get more volunteers for this type of research than seen for many other types of research done with people whom stutter! ;). Re: Most commonly used drug - Alcohol ;-) From: Amber Moncrief Date: 7/17/00 Time: 2:28:54 PM Remote Name: 188.8.131.52 Comments I'm a masters student in speech pathology doing a research paper for a fluency seminar. My topic is drug managed stuttering. If anyone knows of published research studies on this topic, would you mind dropping the name of the article or the journal it's from? My e-mail address is email@example.com Thank you. Differential Diagnosis or one shoe fits all? From: Judy Kuster Date: 10/10/98 Time: 1:34:27 PM Remote Name: 184.108.40.206 Comments Larry, Thank you for an interesting and helpful summary about drugs and stuttering! In the second half of your article you relate information about various drugs that either exaccerbate or decrease stuttering-like behaviors. You also mention that "some of the drugs that induce stuttering in non-stuttering speakers are ones that lessen stuttering in many people who stutter." That sounds like what I have heard in treating kids who may have ADHD with ritalin. They find that the ones who can benefit from it, become less hyperactive and it has the opposite effect on others, whose hyperactivity may be from other causes. You also state, "One of the problems facing the literature base on *drug-induced stuttering* is that the term stuttering has been applied loosely or inaccurately across the research reports." Could the same problem in defining "stuttering" be said of the literature base on drugs that might benefit some PWS? Could it be that the drug treatments used for stuttering have such checkered results because they have been testing one particular drug treatment on a group of PWS who may in fact stutter from a variety of causes? I too have wondered about the reported difference of stuttering when a person has been drinking. Could these differences be diagnostic clues about what may be a causal factor for that individual person? If any of this might be true, how can we develop better diagnositic methods so that we can match clients with appropriate kinds of treatment programs for them. Re: Differential Diagnosis or one shoe fits all? Response to Issue 1: similarity to that seen with Ritalin in treating ADHD From: Larry Molt Date: 10/15/98 Time: 11:45:41 AM Remote Name: 220.127.116.11 Comments Judy Kuster, as always, raises some very interesting issues, and there's actually more than 1 question here (thanks eversomuch, Judy!). Consequently, I'm going to break this into 3 separate issues, and handle each with an individual response. Issue 1: similarity with Ritalin in ADHD: implications for differing etiology? First, Judy mentioned some possible similarities between the use of Ritalin (Methylphenidate HCL) with children with ADHD and the disparate results seen across the different neuropharmacologic agents with stuttering, i.e., that there may be different causes of hyperactivity, and that may explain why all ADHD individuals don't respond the same to Ritalin (with similar implications for stuttering). That's a logical assumption, and there may be some empirical support. I'd like to talk about it from a slightly different aspect. Having done event-related potential (ERP) neuroimaging research with the ADHD population, I agree that there are some interesting similarities. One of the aspects that may apply to stuttering relates to the multi-factor nature of the ADHD diagnosis. It is difficult to find an individual with ADHD who doesn't have multiple disorders. We had a difficult time finding "pure" ADHD individuals, most had either comorbid langauge/learning disorders, comorbid central auditory processing disorders (CAPD), and/or comorbid emotional disturbance (and by the way, all would come up with a diagnosis of ADHD, even though there were very different additional problems). When we could find a "pure" case of ADHD, the auditory neurological processing patterns we were examining were different from those individuals with "pure" CAPD, and still different yet from those with ADHD with comorbid CAPD. While we weren't examining the effects of methyphenidate in this particular research, the literature base would indicate that Ritalin would have had different (or no effects) on processing patterns, depending on whether we had a person with ADHD only, CAPD only, or ADHD/CAPD. So, an alternative hypothesis might be that it isn't because the hyperactivity came from different sources and thus the drug had differing effects, as much as the additional problems each individual child possessed resulted in the disparity in results. I don't think is this necessarily an untenable hypothesis for stuttering; there may a degree of similarity, a single or a few items, in which there is a great deal of concordance across stutterers, however, it is the additional, the concommitant/comorbid problems, that screws up our results. My impression is that a lot of the "equivocal results" we see across stuttering research in certain areas is a result of not using rigid enough or appropriate subject selection criteria. Re: Differential Diagnosis or one shoe fits all? Reply to Issue 2: problem with correct diagnosis: drug-induced vs. treating stuttering with drugs From: Larry Molt Date: 10/15/98 Time: 3:27:54 PM Remote Name: 18.104.22.168 Comments Ah, Good, Ms. Kuster, an easy one to answer - Thanks! Issue 2: Are there problems with accurately identifying stuttering in the neuropharmocolgic treatment literature? I had mentioned that the term stuttering has been too loosely applied in the literature concerning "drug-induced" stuttering, and you asked if the same could be said about the literature base on drugs that have been used to ameliorate stuttering. Another great question, and an obvious point of concern. My experience is that the bulk of the treatment literature has been much better at clearly identifying the subjects as stutterers. This is probably because the disfluencies are presented "a priori", the individual has a pre-existing condition that either in the past has been identified as stuttering by an appropriate professional, or via information reported in the research that indicated that the dysfluencies had followed a developmental pattern like stuttering, rather than having been suddenly "acquired". Unfortunately, even though there is a greater comfort level that these actually were PWS to whom the drugs were administered, there has been little empirical verification of their status in the research, nor have there been many attempts to further delineate patient characteristics, such as severity, specific behaviors, etc. This is especially unfortunate in that several studies have talked about a specific drug as being more effective at eliminating or decreasing secondary/associated behaviors rather than affecting frequency of stuttering, but it is difficult to ascertain how this was decided. Ludlow & Braun (1993) do a great job of discussing some of these problems in their article in JFD. Re: Differential Diagnosis or one shoe fits all? Response to Issue 3: Do differing responses mean differing causes: implications for differential DX From: Larry Molt Date: 10/15/98 Time: 5:35:06 PM Remote Name: 22.214.171.124 Comments Judy Kuster also asked: Issue 3: Is it plausible that drug treatments used for stuttering have such checkered results because they have used a single drug with a group of PWS who may in fact stutter from a variety of causes? and also asked (in discussing differential effects of alcohol) if the differences in responses may be diagnostic clues about what might be a causal factor for an individual PWS? More good issues to consider! The multi-factor model of stuttering is very possible, and given the current status of the research base in stuttering concerning etiology is a very tempting and plausible model. It would also explain the differential response to drugs, and alcohol. It's a model we follow in our therapy approach at Auburn. We start with a full scope/broad based diagnostic evaluation, and follow up with additional testing in areas of concern (i.e., that might be possible maintaining factors), then formulate an individualized therapy plan based on the diagnostic results. Past experience has shown me this is an effective way to do therapy. But I also have past experience with a unitary approach (Shames & Florance's Stutter-Free Speech program) to therapy (Judy's "one shoe fits all") and I saw a significant amount of PWS get significant results with that approach (interestingly, I've see a very diverse group go into such a situation, a group for which my differential diagnosis/individualized therapy model would predict that a unitary approach couldn't work, and have been really surprised by the results). So maybe the multi-factor model isn't necessarily correct. I'm further buttressed in considering the more unitary cause hypothesis from looking at the recent blood flow/neural imaging research in stuttering that points towards similarities in PWS during speech and language tasks (as I mentioned in issue #1). Of course, this similarity is seen in assessing one aspect of what is happening (blood flow/activation of certain neural function areas), and doesn't mean there are similarities in all critical function areas. But it seems to me, at this point, that perhaps as we meet Ludlow & Braun's call to become more empirical, critical, and systematic in our efforts in the neuropharmaceutical research area, we may come up with more of a unitary approach, or at least a better explanation of what's happening. That said, I also have to return back to the multi-factor model in saying that while I have been surprised by the effectiveness of some of the "one shoe fits all" approaches, I have also noted a high relapse rate with them. The question becomes, is that relapse rate a result of the fact that different members of the treatment group had different causes, (and some weren't addressed, or sufficiently addressed) or is it that there was something lacking in that particular therapy approach (and some of the PWS could cope on their own without it, but others couldn't)? I personally don't know which is correct, and don't know which is the best approach to therapy: differential dx and individualized therapy, or a very broad scope unitary approach (if you cover EVERYTHING in therapy, then it will work for everyone!). That also takes us into trying to define success in therapy and there are several excellent papers in the online conference dealing with that issue whose authors address those questions far more eloquently than I can. In read-reading this as I get ready to close, I want to emphasize that my comments towards continuing to improve neuropharmacological research in the interest of looking at a unitary approach or for better decision-making information shouldn't be taken as an endorsement of a neuropharmacological treatment approach. In fact, I feel there are significant drawbacks to a drug treatment approach, a great deal of inherent danger in long term use of psychotropic medication; however, I see it as a useful tool in better understanding etiological factors and treatment approaches. (In fact, from a psychological/psychiatric perspective, the purpose of haloperidol, risperidone, olanzapine, etc., is to reduce conditioned avoidance responses - which also implies behavioral or cognitive approaches can be used as well. One shoe? or many? In looking at this answer, it seems like my shoes have "waffle" soles! NEUROPHARMACOLOGY & STUTTERING From: JIM HOULIHAN email:firstname.lastname@example.org Date: 10/12/98 Time: 9:16:36 AM Remote Name: 126.96.36.199 Comments Thanks for your article. I am interested both personally as a PWS and professionally. I am a Patent Examiner in the UK Patent Office in pharmaceuticals, having done neurophysiology for my first degree. I would like to get involved in any studies. I have read some work from Gerald MacGuire. Have you heard anything about Olanzapine? There was an article in the British Press about a clinician trialing it in Manchester. However, I have been unable to get any further info. Looking forward to hearing from you. Jim Houlihan, Ph.D. Re: NEUROPHARMACOLOGY & STUTTERING From: Larry Molt Date: 10/15/98 Time: 9:15:11 AM Remote Name: 188.8.131.52 Comments Hello Dr. Houlihan I apologize for the delay in responding to your question. I had heard there was an Olanzapine trial taking place and was attempting to get more information for you, but so far, no luck. The drug, Olanzapine, that Dr. Houlihan is referring to is a relatively new drug, an anti-psychotic, thienobenzodiazepine (from the same family as haloperidol and risperidone). Olanzapine has been used to treat schizophrenia, and, like risperidone, has fewer negative side effects than haloperidol. I know of one physician who is currently taking it for stuttering, and I know of another stuttering individual who participated in an apparent trial of Olanzapine for stuttering at the University of Rochester (New York). One, the physician, has reported increased fluency while on the drug, the other felt there was no change in his fluency. That same individual reported more negative side effects, and discontinued participation in the trial. Both reported weight gain while on the drug as being problematic (we joked about being "fat but fluent"). The physician is currently using a very low daily dosage (2.5 mg), and that seemed to help with the weight gain problem. The individual who was in the trial began at a 2 mg dosage, which was gradually increased to 5 mg, and it was at 5mg that he discontinued participation in the trial due to the unpleasantness of the side effects, and lack of effect on fluency (BTW, as Dr. Houlihan is undoubtedly aware, these are relatively low dosages, the initial trials with Olanzapine to treat schizophrenia found no significant therapeutic effect until dosages reached at least 10 mg, and typical dosage tends to be 20 mg or so). I checked with Dr. Christy Ludlow at the National Institutes of Health/National Institute for Deafness and other Communication Disorders and there is currently no intramurally-funded research with Olanzapine for stuttering underway. I'm waiting to hear back concerning any extramurally funded projects. I'll also try and get more information on the University of Rochester study. What does medication do? From: Chuck Goldman Date: 10/17/98 Time: 5:27:05 PM Remote Name: 184.108.40.206 Comments Can any pharmacological agent deal with the multifactorial etiologies we believe stuttering to entail? I'm not yet convinced it can. Re: What does medication do? From: Larry Molt Date: 10/19/98 Time: 12:33:10 PM Remote Name: 220.127.116.11 Comments Hi Chuck! Good question! You asked "Can any pharmacological agent deal with the multifactorial etiologies we believe stuttering to entail? and added that you aren't convinced that it can. I think you've got a pretty common viewpoint, one I share, in part, myself. Three comments to make on that issue: First, we might ask, "does it have to treat all aspects of the disorder?". Gerry Maguire, in his research with risperidone, has stated that he sees the pharmaceutical agent being used to treat part of the disorder, and speech therapy and/or other therapies being used to treat other parts. One could argue that the drug may make it easier, or more effective to utilize additional therapies. Second, as I tried to point out in the article, the majority of the research into neuropharmacological agents to treat stuttering hasn't been designed to cope with such a model. For example, lots of the research has been based on treating a particular aspect of the disorder (e.g., the benzodiazepams, such as haloperidol, work on conditioned responses, such as anxiety), or, even less desirable, have been selected because of serendipitous results seen for a medication prescribed to treat a different disorder, such as the calcium channel blockers. Only recently have we seen attempts to look more empirically, rather than intuitively, for a universal underlying etiology and an appropriate agent to treat it (such as the Wu, Maguire, Riley, et al PET imaging and dopaminergic agent research). Such attempts may not pan out, there may not be an identifiable unitary underlying etiology, but we need to give the process a chance to work. My third response is that most of us have come to that "multifactorial etiologies" model because of the overall equivocal nature of the research base in etiological models for stuttering: we have yet to identify a single agent, and we recognize a great deal of diversity in our stuttering clients. As I said in my reply to Judy Kuster's question, I personally feel comfortable with such a model, and I treat stuttering from that approach. But we need to remember the bulk of the research looking for differences between stutterers and nonstutterers (and thus identifying a possible etiological agent) has been done with adult stutterers, and thereby faces many years of "acquired baggage" concerning the disorder which may cause a greater diversity in what we see in our clients than might have been there when stuttering was first developing (we're no longer looking at precipitating factors, but rather maintaining factors). From a treatment perspective, it may not matter if the maintaining factors now may outweigh the precipitating factor(s), so we must deal with all those diverse problems, however, we don't know if that is indeed the case. Science needs to proceed based on all possible assumptions, not just one. Like I said, great question - I'd love to hear more of your thoughts on the issue. Drug induced stuttering From: Susan Olson Date: 10/18/98 Time: 8:32:56 PM Remote Name: 18.104.22.168 Comments I wish this article would have been able to report a pharmaceutical agent to treat stuttering. Unfortunately there wasn't one. I am interested in the other perspective however. Can you give me any information on the drugs used for attention deficit hyper activity in regards to drug induced stuttering? Re: Drug induced stuttering From: Larry Molt Date: 10/19/98 Time: 5:37:40 PM Remote Name: 22.214.171.124 Comments Hi Susan! Another great question. First as to your comment that its disappointing that research hasn't been able to yet come up with a pharmaceutical agent to treat stuttering. That's a pretty prevalent statement. We're a society brought up on the physcian and majic bullet model - identify the symptoms, ascertain the appropriate drug based on the symptom, take the drug, symptoms cured! It's wonderful when it works that way. The very first PWS that I worked with as a graduate student clinician was a 12 year old boy who had been in therapy for several months, and the type of therapy we were employing at that time required a great deal of practice, lots of concentration, basically, it was lots of hard work. I can remember him saying, after a particularly trying day at therapy, "I just wish there was a pill I could take that would make my stuttering go away. Wouldn't it be wonderful to take a pill tonight, and wake up fluent tomorrow!". Yes, I think both clinicians and PWS wish there was a pill like that, but we sure haven't found one to date. And we also have to consider what the cost of taking such a pill might be - might the side effects, especially if this was a pill that you had to take the rest of your life, be as much of a concern as the drug's effect on fluency? There are few perfect pharmaceutical agents ( i.e., drugs that have no detrimental side effects at all), especially in the area of the neuropharmacological agents. So we want something even more difficult to find: the "perfect pill" for stuttering! Now on to your question. You asked: " Can you give me any information on the drugs used for attention deficit hyper activity in regards to drug induced stuttering?" I have not come across any mention of those drugs in the literature on drug-induced stuttering. I have heard several anectdotal reports on methylphenidate's effect on stuttering, but only one involving stuttering being induced. This was an 11 year old boy who had stuttered as a young child, had apparently recovered, but when he went on methylphenidate (Ritalin) to treat ADHD, experienced a re-occurrence of the stuttering. This was not researched, merely what someone mentioned on a list-serve dealing with stuttering. In terms of other anectdotal reports about the relationship between methylphenidate and stuttering, once again all I have seen are comments on the list-serves and have heard what seems to be equal reports of existing stuttering getting better, remaining the same, or worsening when children with pre-existing stuttering went on Ritalin for ADHD. Sorry I can't be of anymore help - the literature doesn't make it appear to be a problem. The ADHD agents tend to fall in different classes than those associated with possibly causing drug-induced stuttering. Applying Meds in Stuttering Therapy From: email@example.com Date: 10/19/98 Time: 2:46:06 PM Remote Name: 126.96.36.199 Comments Dear Mr. Molt, Thankyou for your article. I was very informativative, and it really made me aware of all of the variables when using drugs with stuttering. My question to you is about appling the use of medictions in therapy. I have heard of doctors and psychiatrists prescribing drugs to patients with different psychological problems (i.e. anti-depressants to a person with mild depression) just to give them a little extra boost when beginning therapy. Once the patient has a handle on dealing with their disorder, they are slowly weened off. In this sense, medication was used as a kick off to recovery. Can medications be used in a similar sense with stuttering with the goal being to provide the person with additional communicative success, and hopefullly increase their fluency? This of course would take into account the indivdual, the nature of their disfluency, and the preceived etiology. Thankyou for your time, and have a good day. Melissa Anderson and Dana Wieck Re: Applying Meds in Stuttering Therapy From: Larry Molt Date: 10/19/98 Time: 6:26:43 PM Remote Name: 188.8.131.52 Comments Hi Melissa & Dana! Yet another great question! If I can rephrase your question, you basically asked if pharmaceutical agents could possibly be employed on a temporary basis, to initially alter the symptoms enough/improving communicative success so that other approaches could be then employed, and the client possibly weaned off the drug. That's not a bad idea at all, and possibly one of the more promising concepts based on our current state of the art. I know of several clinicians who have worked with psychiatrists or psychologists in a team approach with some PWS patients where some of the anxiolytic agents were employed at first, and then gradually weaned off (in some cases) as they (the patient) gained confidence in their ability to produce effective communication. But I also have to be quick to point out that these cases have been the exception, rather than the rule - that the individuals involved generally suffered from communication anxiety to a very disabling extent - not many PWS require such treatment. For the majority, there are other non-pharmaceutical techniques that can be employed (e.g., significantly slowing down the speech rate; use of delayed auditory feedback or frequency altered feedback; use of masking devices, etc). My impressions are that for most stuttering individuals, we have adequate non-pharmaceutical treatments to use as temporary bridges, and I'd prefer not to turn to pharmaceutical agents, because of concerns about side effects (which I don't have to worry about with non-drug treatments). Finally, I should mention that there are other ways that drugs can and have been employed temporarily. I have a colleague, with moderate stuttering, who functions just fine as a state medical official, however, his job requires him to occasionally speak before large groups. He experiences significant panic in these situations, which used to make him avoid such situations whenever possible, and jeopardized staying in that particular job. Psychological counseling to deal with this panic was not successful. He currently takes a strong anti-anxiety drug whenever he has to speak to these large groups. The drug doesn't alter his fluency from what he normally experiences in those situations, however, more importantly to him, he isn't bothered by fear, which used to make him refuse to speak in those situations. Thank you for your interest in stuttering! Drugs increase stuttering? From: Elisa Elena Palumbo Date: 10/20/98 Time: 9:27:49 PM Remote Name: 184.108.40.206 Comments will like to make a question. Maybe, my English won't be great, but I will try to do my best. I am from Venezuela. I once read that the drugs named: Prozac, Zoloft, Wellbutrin and Ritalin, may increase stuttering. Is it true? Thank you. Elisa Elena Palumbo. Re: Drugs increase stuttering? From: Larry Molt Date: 10/22/98 Time: 10:56:42 PM Remote Name: 220.127.116.11 Comments Hola, Ms. Palumbo Thank you for you question; your English was excellent, by the way. You asked about the effects of the following drugs, if they may increase stuttering. 1. Wellbutrin (Bupropion): I am unaware of any published research or reports dealing with Bupropion and stuttering, either having negative effects on treating stuttering, or in terms of drug induced stuttering. Some reports have indicated that the use of antidepressants (e. g., mianserine) have had beneficial effects in stuttering; some others, (fluoxetine, clomiparine, sertraline, etc - the SSRI types) have had mixed results, and have also been linked to drug-induced stuttering in normal speakers. Bupropion is of a different family, and its effects on serotonin, norepinephrine, and dopamine uptake are much milder. This may be why is there have been no reports of positive or negative effects. 2. Zoloft (Setraline) & Prozac (Fluoxetine): both of these antidepressants are from the family known as selective serotonin reuptake inhibitors. Following Brady's 1991 review of drug treatment of stuttering, in which he speculated that this new class of drugs might be worth investigating, there were multiple reports in the literature of their usefulness. Most have had somewhat mixed success in treating stuttering, why clomipramine possibly having the most success (e. g., Gordon, Cotelingham, Stager, Ludlow, Hamburger, & Rapoport - 1995, reported favorable outcomes on several rating scales when clomipramine was compared to desipramine in a double-blind crossover trial with an initial placebo phase with 17 stuttering subjects). So in many stuttering subjects, Zoloft or Prozac may have some beneficial effects. However, all three (fluoxetine/Prozac, clomiparine, sertraline/Zoloft) have also been linked to causing drug-induced stuttering in some normal speakers. 3. Ritalin (methylphenidate): I know of only one reported case of methylphenidate increasing the severity of stuttering. This was reported by Burd & Kerbeshian (1991), and was observed in a 3 year old girl who was receiving Ritalin for the treatment of hyperacctivity. As this is a widely used drug in children, I would have expected many more published reports of negative effects on stuttering if it appeared to have any consistent negative effects on children who stutter. It's important to note that while none of the four drugs you mentioned appears to consistently cause problems for people who stutter, one can't rule out occassional negative effects. Clonidine From: Carolyn Hochanadel Date: 10/21/98 Time: 10:54:38 PM Remote Name: 18.104.22.168 Comments A parent of one of my students asked if it was known whether or not Clonidine would increase the stuttering her child is experiencing. I know this is a last minute request. Re: Clonidine From: Larry Molt Date: 10/22/98 Time: 8:29:08 PM Remote Name: 22.214.171.124 Comments Hi Carolyn! You didn't indicate exactly why the clonidine (Catapres) was being considered, whether as an agent to treat stuttering, or to treat some other disorder. Its an alpha2 norandrenergic receptor agonist that is used to treat many things, including high blood pressure, migraine headache, withdrawal symptoms during detox from drugs/alcohol, Tourette's syndrome, anxiety, agressiveness, and attention deficit disorder. The dosage will vary widely, depending upon the nature of the disorder to be treated, as well as the age/size of the individual. Because of beneficial reports of its effect on treating Tourette's disorder as well as other tic disorders, and the possible similarity of some of the symptoms of those disorders with stuttering, its effect as an agent in treating stuttering has been examined. Vink, et al, in a 1992 letter in the American Journal of Psychiatry, using an open trial, reported favorable results in 5 of 7 children who stuttered (these children did not have Tourette's). A later and more elaborate study double-blind crossover study by Althaus, Vink, et al (1995) with 25 stuttering children in the Netherlands did not find any decrease in the frequency of their stuttering. So, if clonidine is being considered to treat the stuttering, there doesn't seem to be any benefit. If it is being considered to treat ADHD, one wouldn't expect it to have an effect on the stuttering (either improving it or exacerbating it); if it's to treat Tourette's, there have more reports of beneficial effects on stuttering within this population. Hope this helps; feel free to e-mail me at firstname.lastname@example.org if you have further questions. olanzapine trials From: Amanda Mahaffey Date: 3/25/99 Time: 10:55:05 PM Remote Name: 126.96.36.199 Comments Hi, I am a stutterer and am interested in participating in any experiments taking place with Olanzapine. Could you please give me any contact information you might have. Thanks so much. -Amanda Hola pariente From: Daniel García Molt Date: 9/14/99 Time: 2:02:14 AM Remote Name: 188.8.131.52 Comments Hello Larry: My name is Daniel García Molt. No hablo muy bien inglés. Y supongo que nunca entenderás estas palabras. Lo cierto es que hace aĖos que busco algún pariente cuyo apellido sea Molt y provenga de Stuttgart, Alemanía, pero todos los Molt que encuentro son químicos o bioquímos o todavía peor, expertos en economía. Lo cierto es que me parece que mi parentezco con todos los Molt se diluye en un océano inmenso en el cual nadie puede darme algún dato de esa familia perdida a principios de la década del 10 en Alemania. Toda esta cháchara de mi Email se debe a que leí que eres un Molt experto en alcohol, (O por lo menos es lo que entendí) y dado que hoy he tomado alcohol : estos son los resultados. Bueno, amigo, si tienes algo que ver con los Molt de Sttutgart y, particularmente con mi abuelo Guillermo Molt, te recomiendo que no contestes, porque aquí en Argentina donde vivos no encontrarás otra cosa que parientes muy divertidos pero absolutamente entregados a todo aquello que no tiene mucho que ver con la ciencia. Ahora si tienes que ver con esos alemanes y te interesa escribirme mi Email es: email@example.com y tienes un pariente con quien hablar. Un placer. Daniel.