I had mentioned in previous post that clinical trial involving pagoclone, which potentially could be the first drug approve by the FDA for the treatment of stuttering is currently taking place. Pagoclone was initially developed by the pharmaceutical company Indevus. Pagoclone is a nonbenzodiazapine class of drug that works similarly to benzodiazapine (such as diazepam aka valium, xanax aka alprazolam , lorazapam aka ativan) that is on a receptor called GABA(a). Pagoclone binds to the GABA(a) subunit 2alpha and 3alpha and bypasses the 1alpha subunit which is responsible for the sedative and anmestic effect of benzodiazapines. GABA (gamma amino butyric acid) is a brain neurotransmitter receptor that brings a calming effect when stimulated (thus reducing anxiety). It should be noted that the exact mechanism of pagaclone is not known.
Research have confirmed that people who stutter have excess dopamine in the brain and it is this excess dopamine that interferes with the circuitry of the basal ganglia (brain components consisting of substantia nigra in the midbrain, the subthalamic nucleus, the striatum specifically caudate and putnum) that is responsible for movement initiation which also involve speaking (a motor phenomena as well). Pagoclone also help to reduce levels of dopamine (exact mechanism not known) and thus decrease stuttering.
As I have stated in my previous post that Dr. Gerald Maguire from the University California at Irvine (UCI) is one of the leading experts on stuttering and is one of the main investigators in the pagoclone research. Dr. Maguire also opened up the first biological stuttering clinic in the USA on UCI campus to treat people who stutter by using different types of antidopaminergic drugs such as abilify, geodon, and zyprexa. I was invited to the UCI campus by Dr. Maguire in my 4th year of medical school 10/2007 and I got to see the remarkable improvement of fluency that these drugs were making in many people who stutter. Some of the side effects of these drugs can be weight gain, sedation, diabetes (in some cases) and so proper follow up is needed.
I decided to talk about this topic today because I recently saw that Dr. Sanjay Gupta of CNN did a story of Dr. Maguire and the pagoclone research. The link to the video is below watch it and leave your comment(s).
http://www.youtube.com/watch?v=UxGtzkjvfUA
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