Managing Stuttering With Psychiatric Comorbidities: Gerald McGuire, MD

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"Stuttering has been recognized since the dawn of history and occurs across every culture and language, yet we still have no FDA-approved treatments. It is not an anxiety disorder, though social anxiety often accompanies it, and we must focus on addressing the underlying neurologic condition."

From a neurology perspective, stuttering is a complex speech fluency disorder that arises from disruptions in the brain networks responsible for timing, motor control, and language processing. There is evidence that stuttering involves abnormalities in dopaminergic signaling, which may explain why some dopamine-modulating medications show benefit in subsets of patients. Neurologists also recognize that stuttering can co-occur with other neurodevelopmental or neuropsychiatric conditions, such as ADHD, anxiety, or tic disorders.

The Stuttering Treatment and Research Society (STARS) recently completed its first annual Research & Education Conference for medical professionals, held September 13^th at The Ritz Carlton in Laguna Niguel, California. The full-day event was the first entire conference dedicated to Continuing Medical Education in stuttering, applicable to all licensed healthcare professionals, including physicians, psychologists, speech-language pathologists, and nurses.

During the meeting, Psych Times, a sister publication to NeurologyLive^®, sat down with Gerald A. McGuire, MD, president and founder of STARS, to discuss the unmet needs of stuttering, as well as the best approaches to treating patients with comorbid psychiatric conditions. McGuire, who also serves as a professor and chair of psychiatry and neuroscience at UC Riverside School of Medicine, clarified that stuttering should not be mistaken for an anxiety disorder, although social anxiety often coexists and requires careful management. Furthermore, for psychiatrists treating comorbid conditions such as ADHD or tic disorders, he stressed the importance of avoiding medications that may worsen stuttering and pointed to dopamine antagonists and partial agonists as the most promising pharmacologic approaches currently under investigation.