**Disclaimer: I am not a medical professional. Also bit long of a post but for those who truly see their stutter as detrimental to their well-being, it is a completely viable option.** --- TLDR: I think it has to do with dopamine (Broca's Area) in general and that people will either respond to amphetamines or antipsychotics to treat their stutter, which is paradoxical. Dextroamphetamine helps mine personally, but it can also wear out. Dopamine is complicated. Desoxyn (Prescription Methamphetamine) cured mine for awhile but its too addictive and wears off after long-term use, unlike with dopamine antagonists. Read my favorite paper, [The Dopamine Dilemma](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2898838/), for a better understanding of how complex dopamine can be (and neuroscience in general). **I also wrote an article/paper about a potential treatment for treating stuttering by using tDCS over the Broca's Area**, which can be read [here](https://medium.com/@joseph.tortorelli5/notice-warning-fb44c791a406). Its funny because after I had released that article predicting the correct placement, a clinical trial showed up with the same placement producing promising results for treating stuttering. Before anything, I suggest you read [this](https://thelastpsychiatrist.com/2007/07/the_most_important_article_on.html) blog post that explains how anti-psychotics works and how taking a low dose ≠ high dose in terms of what they do, as explained in the article. I found Zyprexa @ 15mg to treat my stutter long-term and reduce it 90% (no joke). I still decided to get off of it because it ruined my creativity and analytical skills. There are also reports of people who don't have a stutter producing a stutter on anti-psychotics, furthering the question of how dopamine exactly plays a role in stuttering. People with stutters tend to have higher diagnosis's of ADHD, Substance Abuse Disorders, and Tics, all which relate back to the broca's area in some way, so my theory would be that its related to dysfunction there which is backed by a lot of studies: * [Reduced perfusion in Broca's area in developmental stuttering.](https://www.ncbi.nlm.nih.gov/pubmed/28035724) * [A review of brain circuitries involved in stuttering](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4233907/) * [Second-generation antipsychotics effective for stuttering ](https://www.mdedge.com/psychiatry/article/132137/schizophrenia-other-psychotic-disorders/second-generation-antipsychotics) * [Wikipedia - Broca's Area](https://en.wikipedia.org/wiki/Broca%27s_area#Stuttering) On the other-hand, some people may respond to stimulants instead (like me): * [Stuttering. The effect of treatment with D-amphetamine and a tranquilizing agent, trifluoperazine. A preliminary report on an uncontrolled study. ](https://www.ncbi.nlm.nih.gov/pubmed/5836893) * Of 28 patients to whom d-amphetamine was given, 14 showed improvement after one month's treatment. Eight more showed improvement when trifluoperazine was given for one month to those who did not improve on d-amphetamine. In many cases, improvement was sustained at least six months after treatment was discontinued. Treatment with d-amphetamine was apparently more effective in patients with functional than with organic retardation. --- Its only when you are on the therapeutic dosage that is prescribed for things like bipolar / schizophrenia that it will affect the stutter. To get the effect for reducing the stutter, you need to be on the higher-end of the dosage where D2 is blocked, as the drug will first bind to other receptors and once they are filled, it will it bind to D2 which is where the main effects come from. For stuttering, these changes are enormous in my opinion (and I am very against the prescription of these drugs in general so thats saying a lot). From The Blog Post: > Instead of thinking that the drug binds to all receptors simultaneously, a better analogy would be a champagne fountain, like at a wedding. Except I hate champagne, so pretend it is a rum fountain. Rum fills the top level, overflows into the second level, then that overflows into the third, etc. You can't get anything into level 3 until you fill levels 1 and 2. And, once you've filled level 1, you can't put anything more into it. > DOESN’T THE BOX CLEARLY SAY ANTIPSYCHOTIC? Yes, it does. Weird, isn’t it? > Until this drug is blocking a significant number of D2 receptors, it is not functioning as an antipsychotic. Important: the antipsychotic effect of one molecule of Seroquel isn't so weak you just can't see it-- it is exactly and precisely zero. > The drug can't be called an antipsychotic unless it is behaving as an antipsychotic, regardless of the product labeling. --- # Conversion Here is a good guideline for reaching the D2-Blocking effects of anti-psychotics which have a high chance of helping stuttering: > 10mg Zyprexa = 500mg Seroquel = 3mg Risperdal= 120mg Geodon. (4) So there are still many different theories on why stuttering occurs and some stutters may be different from others (mine was hereditary and environmental combined). The theory I trust and believe the most is that it has to do with the Broca's Area of the brain which is related to dopamine. Dopamine, in itself, is a complicated topic to get into. Its not as simple as increasing / decreasing dopamine levels. There are different subreceptors. Ironically, I have found that both dopamine antagonists (antipsychotics like Seroquel, Zyprexa, Risperidone) and dopamine releasers (dextroamphetamines, methylphenidate, and even partially nicotine) can help stuttering. I find that long-term use of amphetamines or high doses of amphetamines lose their effectiveness at treating stuttering. Desoxyn (Prescription-Grade Methamphetamine) almost completely cured mine but it being so addictive, its not sustainable but it does point furthermore to an issue with dopamine. I can 100% vouch with dopamine antagonists helping stuttering long-term and being extremely effective, but they also come with lots of side effects and risks. I personally found that after growing out of childhood, it became more manageable. I can write more if more people are interested about some other substances I have had success with (like Aniracetam, Noopept, and low-dose benzodiazepianes). But I always write too much anyways. So I'm gonna leave it at that. Feel free to read the resources and my article linked at the top. I know it is a REALLY difficult issue to deal with. It probably was one of the main causes of my drug abuse / depression / anxiety problems. I can't say for certain it will get better over-time or not but it did for me and my mother. This topic I am passionate about as I know how much pain/trouble it brings not being able to communicate well with others and leading to isolation. If I have time, I will write up and maybe see if I can pull some strings to see if I can get trials for tRMS (which uses magnetics to help rewire the brain).