Abstract
We are aware of three case reports of clozapineinduced stuttering possibly mediated by epileptogenic brain activity. We report a similar case. A few days after initiation of clozapine for treatment-resistant schizophrenia, our patient started experiencing myoclonic jerks at night, facial tics and unusual speech, mainly explosive, and stuttering, clearly noticeable at a dose of 300 mg. The dose of clozapine was gradually increased up to 500 mg daily with no improvement noted in the unusual movements. These unusual effects worsened with stress. On an empirical basis, a trial of sodium valproate 200 mg twice daily was initiated which lead to gradual but steady improvement. We attempted to stop the valproate but the symptoms worsened, therefore the dose was increased again. The symptoms attenuated but subsided completely once the dose of clozapine was reduced from 500 mg to 300 mg. The dose of Valproate remained unchanged.