Pruett Dillon G, Hunter Christine, Scartozzi Alyssa, Shaw Douglas M, Kraft Shelly Jo, Jones Robin M, Shuey Megan M, Below Jennifer E
Vanderbilt Genetics Institute, Vanderbilt University Medical Center, USA.
Lipscomb University College of Pharmacy and Health Sciences, USA.
J Commun Disord. 2025 Jan-Feb;113:106475. doi: 10.1016/j.jcomdis.2024.106475. Epub 2024 Nov 19.
Drug-induced stuttering is a phenomenon where the onset of stuttered speech is caused by exposure to pharmaceutical chemical substances. This acquired form of stuttering features many of the same overt speech behaviors as developmental stuttering. Investigations of drug-induced stuttering have been limited to adverse drug reaction reports and case studies. This study leveraged electronic health records (EHRs) at a major university medical center to identify drug-induced stuttering within medical notes, followed by classification of implicated drug types.
A previous systematic EHR review of approximately 3 million individuals to identify cases of developmental stuttering resulted in 40 suspected cases of drug-induced stuttering. In the present study, these cases were reviewed comprehensively to evaluate: name, class, and mechanism of action of suspected drug, level of evidence for the implicated drug as a causal agent, therapeutic measures taken, and progression or remission of stuttering.
Eighteen different drugs were linked to possible drug-induced stuttering in 22 individuals. Antiseizure agents, CNS stimulants, and antidepressants were the most common drug classes implicated in drug-induced stuttering. topiramate (Topamax) was the most commonly implicated drug across all records reviewed.
This study represents the first analysis of health system data examining drugs implicated in drug-induced stuttering in a clinical setting. Augmenting previous case reports and database reviews, a variety of drugs were identified; however, improved reporting of drug-associated speech fluency changes within the EHR are needed to further amass evidence for suspected drugs and their associated epidemiological and clinical characteristics.
药物性口吃是一种因接触药物化学物质而引发口吃的现象。这种后天形成的口吃形式具有许多与发育性口吃相同的明显言语行为特征。对药物性口吃的研究仅限于药物不良反应报告和病例研究。本研究利用一所大型大学医学中心的电子健康记录(EHR)来识别病历中的药物性口吃病例,随后对相关药物类型进行分类。
先前对约300万人进行的系统电子健康记录回顾,以识别发育性口吃病例,结果发现了40例疑似药物性口吃病例。在本研究中,对这些病例进行了全面审查,以评估:疑似药物的名称、类别和作用机制、该药物作为致病因素的证据水平、采取的治疗措施以及口吃的进展或缓解情况。
18种不同药物与22名个体的可能药物性口吃有关。抗癫痫药、中枢神经系统兴奋剂和抗抑郁药是与药物性口吃最常相关的药物类别。托吡酯(妥泰)是所有审查记录中最常涉及的药物。
本研究是首次对临床环境中与药物性口吃相关的药物进行卫生系统数据分析。在以往病例报告和数据库审查的基础上,识别出了多种药物;然而,需要在电子健康记录中改进对药物相关言语流畅性变化的报告,以进一步积累疑似药物及其相关流行病学和临床特征的证据。