Sunday, October 21, 2007

Trying out medication: Week 4

Here is the four-week report on taking Zyprexa: see here and here for earlier reports:
Four weeks into the Zyprexa Zydis and so far, so good. The first week or so was very tiring indeed, my energy levels were sapped and I was very sedated. After about 10 days my energy levels resumed and I felt fine. My facial ticks/secondaries are all but gone, as I don't have to struggle so much to get the words out. In the past my stomach used to get into knots from forcing out the words, this has also stopped as the words seem to flow better. I no longer think about speech all the time, its a refreshing change after 30+ yrs as my mind seems clearer and I can focus more. I am less anxious in speaking situations. I am still a stammerer, don't think that this drug is a "magic cure" because its not, what it enables me to do is relax and seems to make the speech timing improve as I don't have the blocks anymore when initiating speech. Weight gain has been slight - I would say about 5-6lbs, however my weight fluctuates by 2-3lbs per week up and down anyway, and I can exercise off this weight gain without any worries. To sum up....."So far so good"........ My doctor said that when he saw me after 3 weeks, he could see an improvement in my speech and my eye contact. I will be having a blood test at 6 week and may well increase the dosage to 10mg as long as the sedation effect is not too much. I imagine that this treatment works better on some sub-types than others, and its working so far. I will let you know what the blood tests show in 2 weeks.

10 comments:

Anonymous said...

What would be interesting in this single subject drug trial is for the subject to video tape himself during a reading sample and some natural conversation over the weeks and then have independent raters determine if his fluency and secondary characteristics improved. Without such measures all we have are the individual's subjective experiences and, while this may sound harsh, this is empirically worthless.

Anonymous said...

Prior to starting the treatment, there was a video tape taken of me doing a sample reading and some natural conversation with the Dr.

Over the course of the treatment, this will be monitored and compared to the base reading.

So it will not be empirically worthless.

Kind regards

Stephen

Tom Weidig said...

Reported subjective experience is also a reality, and a conflict between the report of subjective experience and the outside observer MUST BE explainable at least in theory, but might not be easy to do.

It is not my intention to use the first-person reports to prove the efficacy of stuttering medication. Trials are specifically done for such a task. Nevertheless, it is interesting and educative to have such first-person reports, especially as they might give information that cannot be picked up by a listener. However, I will make sure that we get reports for the next months to keep track.

Even if independent raters do not see an improvement, one still needs to explain why the person should experience improvement. It cannot be placebo because no improvement happened. So either the person is deluding himself, or experiences an improvement IN TERMS OF SOMETHING DIFFERENT TO FLUENCY OR SECONDARY SYMPTOMS. As I said in a previous blog, stuttering does not only produce secondary symptoms like avoiding of blocks or tension, but it also reduces the stutterer's ability to think clearly. Maybe some medication reduces the impact of limbic activity to the brain while stuttering. (Just a thought...)

Anonymous said...

Hi Stephen

Excellent to learn that a baseline speech sample was collected! I wonder if the changes (or non changes) in stuttering counts will reflective your subjective improvement? I think there is room for middle ground here and Tom may have found it in his comments.

Anonymous said...

What about making daily digital audio recordings during normal conversation at home and count percent syllables stuttered from a timed sample of those?

They can be recorded randomly on a laptop- sitting on a side table or even a kitchen counter without the subject being aware of when it is recording or not recording. If a long enough sample is obtained, a timed segment of speech that is clearly audible can be selected out of the entire sample taken.

Jerome said...

I'd be really interested to know if it's really because of the medication or simply because he feels more confident.

I've also got spectacular videos of myself before and after therapies (without medication). Doesn't necessarily mean you're healed ...

But generally I've got a lot less ticks and blocks than in the old days.

Don't get me wrong though, a medication (without significant side-effects) to get totally rid of stuttering would be very nice and appreciated!

Anonymous said...

Hi Jerome,

I am sure that some of the improvements in my speech are because I am more confident, its the upwward spiral as opposed to the usual downward spiral that we usually have when we speak.

I am not looking at the medication as a "cure", however if it will reduce the blocks and give me more confidence in speaking situations, its not a bad thing!

As long as the side effects are manageable, and to date they have been I will give this medication some time and see how it goes.

Jerome said...

Stephen:

If the medication helps to break the downward spiral then that's a good thing!

Ideally it should be possible to retain this upbeat feeling later on without the meds?

I'm curious about how it will go on. Keep us updated! :)

Anonymous said...

@Tom:
I love to read your blog. I´m from Germany and of course i am stutterer.

I´ve tested Rivotril but after a few months i felt that the effect was gone... at first for sure... i felt like free from stammering.


Now i´m going to test zyprexa. I hope that effect will stay a little bit longer. I was so great to spech without fear.
Hope Zyprexa will be take the same effect for longer time.

Maybe you give us some more informations about your zyprexa medicamentaion (how much mg, feelings eg).

Daniel Schulte from Germany
maybe you will have my mail address: dietrich@arcor.de

King regars, Daniel

Courtney said...

Hello everyone,
My name is Courtney and I am one of the few female stutterers out there. Over the years, my speech has been getting worse and worse, with many blocks.

I have been thru years of speech therapy as a child, but I stopped going. I've never taken any medication for my speech, and I was wondering if you thought that Zyprexa is worth a shot.

Has speech therapy worked for any of you out there as adults? Do you think that I should try to go back or just try the medication by itself?

Thank you so much!