PubMed · 5579203
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A D Korczyn. 1971-06-05. Hiccup.. https://doi.org/10.1136/bmj.2.5761.590-c
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The etiology of stuttering is controversial. The prevailing theories point to measurable neurophysical dysfunctions that disrupt the precise timing required to produce speech. Stuttering is a common disorder that usually resolves by adulthood. Almost 80 percent of children who stutter recover fluency by the age of 16 years. Mild stuttering is self-limited, but more severe stuttering requires speech therapy which is the mainstay of treatment. Delayed auditory feedback and computer-assisted training are currently used to help slow down speech and control other speech mechanisms. Pharmacologic therapy is seldom used, although haloperidol has been somewhat effective.
When schizophrenia is first diagnosed antipsychotic therapy should be started quickly as the longer the initial psychosis remains untreated the worse the final outcome will be. Aggression or agitation is best managed with a sedative given with a non-sedating antipsychotic until the antipsychotic effects of the latter appear. Because patients' first experiences of side effects are important determinants of compliance, serious consideration should be given to using a drug with low extrapyramidal side effect (EPS) liability, e.g. risperidone. In a recent trial in 183 patients with first episode schizophrenia, risperidone was at least as effective as haloperidol in reducing total PANSS scores, PANSS positive, negative, general psychopathology scores and derived BPRS scores. At endpoint, 63% of the risperidone group had improved by 50% or more (total PANSS) compared with 56% in the haloperidol group. The incidence of EPS was significantly lower in the risperidone group.
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