[20F] Experiencing worsening stuttering with a complex psychiatric history

Patient Description

A 20-year-old female with a history of ADHD, Tourette Syndrome, Bipolar Disorder, and Social Anxiety Disorder reports a worsening stutter that began mildly during a period of medication adjustment in 2018 and has since become more pronounced. The stuttering initially coincided with the use of topiramate for severe Tourette Syndrome and subsided upon discontinuation. It reemerged and worsened following a switch to venlafaxine for social anxiety and a recent increase in risperidone dosage. The patient's social anxiety has improved with current medication, but the stuttering persists and is most pronounced in social situations, particularly at school. The patient's medical history includes a manic episode in December 2016, initially misattributed to ADHD and exacerbated by an increased dose of lisdexamfetamine, later treated with risperidone. The patient's stuttering did not occur during a period of psychotic depression treated with risperidone and sertraline. Current medications include lisdexamfetamine (reduced dose), risperidone, and venlafaxine, with partial response to anxiety.

Arora's Assessment

What might be happening

Based on the information you've provided, it seems that your stuttering may be related to the medications you're taking for your various conditions. Here are some possibilities:

Medication-induced stuttering: Certain medications, including those used to treat ADHD, bipolar disorder, and anxiety, can cause or exacerbate stuttering. This is particularly true if the stuttering started or worsened after a change in medication or dosage.
- Treatment typically involves adjusting the medication under the supervision of a healthcare provider.
Anxiety-related stuttering: Anxiety can exacerbate stuttering, particularly in stressful situations. Although you mentioned that your social anxiety has improved with medication, it's possible that residual anxiety is contributing to your stuttering.
- Treatment often involves cognitive-behavioral therapy (CBT) to help manage anxiety, as well as speech therapy for the stuttering itself.

Remember, only a healthcare provider can diagnose your condition and determine the cause of your stuttering. It's important to discuss these symptoms with them.

What you can do

Talk to your doctor: Discuss your symptoms with your healthcare provider. They may want to adjust your medications or refer you to a speech-language pathologist for further evaluation and treatment.
Practice relaxation techniques: Techniques such as deep breathing, progressive muscle relaxation, and mindfulness can help manage anxiety, which may in turn help with stuttering.
Speech therapy: Working with a speech-language pathologist can provide strategies to improve fluency and manage stuttering.

What you should look out for

If your stuttering worsens or begins to significantly interfere with your daily life, seek medical attention promptly.
If you experience other side effects from your medication, such as dizziness, confusion, or changes in mood or behavior, contact your healthcare provider immediately.
If your anxiety worsens or you begin to feel overwhelmed, seek help from a mental health professional or a trusted person in your life.

Remember, it's important to consult with your healthcare provider for a formal diagnosis and treatment plan.

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9 mo ago

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[20F] Experiencing worsening stuttering with a complex psychiatric history

What might be happening

What you can do

What you should look out for

Experiencing symptoms?