Predictors of Effect of Atypical Antipsychotics on Speech

Abstract

Background:Most of the studies have looked into the effect of typical antipsychotics on speech secondary to tardive dyskinesia.Aims:This study was aimed to explore the factors predicting the effect of atypical antipsychotic medications on the production of speech.Materials and Methods:One hundred and forty patients on stable regimen of three or more months on risperidone (92), olanzapine (28), aripiprazole (14), and clozapine (6) were recruited for the study. Speech was assessed by maximum phonation duration task, s/z ratio, diadochokinetic task, acoustic analysis and Frenchay Dysarthria Assessment (FDA). Extrapyramidal symptoms (EPS) were assessed by Simpson Angus scale.Statistical Analysis:Spearman correlation analysis was carried out to find the association between speech parameters and continuous variables. Effect of EPS, duration and dose of antipsychotic treatment on speech parameters was compared using Mann-Whitney test.Results:The risperidone group differ from other antipsychotics groups significantly in s/z ratio (0.07), FDA-total (0.23) and FDA-reflex (0.25). People who took antipsychotic for more than 2 years had lower score of FDA-palate (P = 0.042), and FDA-respiratory (P = 0.04) and higher values in noise-harmonic ratio (P = 0.011) and maximum /fundamental frequency (MFF) for males (P = 0.02). Effect of EPS was seen on MFF for males (spearman correlation coefficient = 0.34) and on almost all sections of FDA (spearman correlation coefficients = -0.2 to -0.33).Conclusion:Both duration of use and propensity of atypical antipsychotics to cause EPS can influence the speech performance of the patients. This information can be useful, particularly in people with the requirement of high quality speech.

Language disturbances in schizophrenia: the relation with antipsychotic medication

“…Indeed, some have suggested that antipsychotic medication improves communication since it is associated with reduced incoherence and tangentiality 53 . However, there is also some evidence that antipsychotics reduce intelligibility of speech and induce poverty of speech 20,21 . Antipsychotics can also cause acute laryngeal dystonia 54 or laryngeal dyskinesia 55 , causing stridor and thereby negatively impacting speech.…”

“…However, little is known about the remedying effects of antipsychotic medication on language disturbances. Importantly, there is reason to assume that antipsychotic drugs may contribute to some of these language perturbations 20,21 . Specifically, antipsychotic drugs' effects on dopamine receptors can be hypothesized to impair language, in several ways.…”

“I Stopped Hearing Voices, Started to Stutter” - A Case of Clozapine-Induced Stuttering

“…It has been related to the duration of antipsychotic treatment and extrapyramidal side effects including dopaminergic supersensitive states such as tardive dyskinesia and dystonia. [6] Clozapine, with its lower dopaminergic affinity, is less likely to be involved in extrapyramidal side effects-related pathogenesis. Apart from dopamine, multiple neurotransmitter systems, including muscarinic and α-adrenergic receptors, where clozapine exerts its influence have also been implicated.…”

“…[5] There is literature on iatrogenic causation with antidepressants and antipsychotics such as risperidone and aripiprazole. [6] Although rarely, clozapine has also been reported to cause stuttering. A retrospective study in Ireland estimated the prevalence of stuttering as 0.92% (6 of 654) in patients treated with clozapine.…”

“Slurred Speech and Tremors Resulting From Antipsychotic Therapy in a Patient With Bipolar Disorder: A Case Report”

“…Antipsychotic medications have the ability to disrupt speech processing mechanisms because they affect the neuromuscular system. Speech problems, particularly acquired types, can affect communication and life experiences [4].…”