Slurred Speech

[mab52]

I've had some trouble lately with dry mouth and what seems to make it difficult to move my tongue--it's hard to speak and probably comes out slurred a bit. I'm thinking it might be from the meds, but maybe it's just FM. I'm taking sertraline, amitryptaline, lisinopril, flexeril, and tramadol. I don't think the tramadol is involved because I was experiencing it beforehand. And none of my drugs are in high dosage and the overall side effects are minimal.

Normally I don't worry about this, but I am sometimes service leader in worship in church. Nobody would accuse me of drinking, but it's problematic.

Any ideas?

[ronr]

Biotene I think is the name of the product they recommend for dry mouth.  It helps keep your mouth moist, and dry mouth promotes tooth decay as if you didn't have enough incentive. 

[foxgrove]

I've taken some of these and know flexeril totally dried me out as did tramadol.. and yes.. I completely understand.  As Ron said, biotene in all it's many solutions really helps.  I also keep a water bottle no more than a foot from me at all times and it gets drained on a very regular basis.

There are a few problems that the dry mouth can cause.. keep up with your daily brushing and flossing... cavities can be a very real problem with dry mouth... as well, you will likely end up having to scrape your tongue as there is less defoliation of the hairy cells on your tongue.  It's called hairy tongue and it's totally harmless but it means that your breath can take on odd smells and your tongue takes on an odd hue depending on what you eat.  Proper oral health just became more important that's all.

Don't worry at all about the congregation.  Just explain that your meds are giving you dry mouth.  It's REALLY no big deal.  Please don't see this as something you need to hide or be ashamed of.  It's just part of dealing with fibro.

[mab52]

Thanks guys. I still have a problem with my tongue being stiff. That occurs even without the dry mouth. Weird!

[foxgrove]

I have the same issue.. it isn't that it's stiff to touch.. just stiff to use.  Words do NOT come easily any more..  Between not remembering what I am going to say and trying to say it.. let's just say it's a challenge!!!

[countryboy]

If you are like me, the dry mouth can be much worse on some days than others.  My wife says that she can tell when I am having a bad case of the dry mouth because my words sound a little slurred and that I start to lick my lips more than normal.

Aren't those gals nice to tell you that you have a fuzzy mouth?

[Tbiggs]

Ahh,

Just tossing this out there.

Cymbalta is known to cause cotton mouth.

-B-

[mab52]

I'm still struggling with this problem, but it's becoming a bit more weird. I seem to have an excess of moisture and I'm unconsciously swallowing at frequent intervals. I'm thinking this is what's called tardive dyskinesia. Now I guess this means I'm going to look like I'm always out to lunch as well as being that way! 

I wish I can figure out what's causing it. My guess is the sertraline even though I'm not on a high dose.

[Anooniemouse]

When I hear the phrase slurred speech I think of three things immediately, and thankfully they are things you can do something about. Thankfully most of the initial tests for this stuff you can run under a complete metabolic panel w/ electrolytes (fairly cheap, simple, blood test), the blood pressure cuff, and pee into the cup to measure electrolytes & sugar there.

The first thing I think: How is your blood pressure? Any vascular issues? Calcium high (it can scar blood vessels, leading to damage)? This is similar to the type of damage that comes from a stroke, just over a longer period of time.

The second thing I think of is that you might be short on an adrenal hormone, and it might be worth a visit to the endocrinologist to check your hormone levels. In particular cortisol, aldosterone, and while at it run a basic electrolyte panel. If your cortisol is dropping below the range, it can cause intermittent slurred speech issues, as well as hearing, and along with aldosterone being off could easily account for the dry mouth.  Your GP can run some of these test, but be aware that the "normal" ranges for a lot of tests were set by people who came into emergency rooms, and that is hardly a normal population. If the cutoff range is say 12 nmol/mL for cortisol, you are stressed to the hilt from life or physical pain, and your test comes back 12.5 nmol/mL ...you could still be swinging into the deficient range, and still have an adrenal problem that needs to be accessed with an ACTH stimulation test, glucose tolerance test, and a few other exams. The initial blood work is fairly cheap, but the ACTH stimulation test is an infusion (both short, and long), and will set you back some $$ if you don't have insurance, or don't have good insurance. This has some advantages of also being able to rule out diabetes, and a few other problems while doing the testing (and it can cause similar problems if your blood sugars are swinging far enough off, just not as likely to as if your cortisol is off).

The third thing I think of: SSRI's, TCA's, and SNRI's *all* can cause motor ticks such as tardive dyskinesia, teeth grinding, restless legs, and none of these are good things. I took the drug Effexor briefly, and it caused uncontrollable muscle movements in my legs. I've since sworn off all antidepressants as they just aren't worth the bad side effects for the minimal or non-existent improvements I experienced on them. The muscle movements in my legs eventually got better, but it was a long road (more than 9 months) to see real improvement after I went off. It was also miserable going off of Effexor.

There are some other things ... but I think you'll find your answer in one of those. Definitely talk to your GP, describe what is going on, and get him to do a workup.

[Gator]

Just registered today and found this topic interesting. The adrenal gland hormones was interesting. I find I start to slur is when I get exhausted. At that time I also start to spit little balls of saliva with my speach.

[mab52]

I'm on a new med, so the problem isn't showing up (yet!) I expect to be adding something else in about a week, so the experiment continues.

Pushing 60 is hard enough without feeling like a high school chemistry experiment

[WolfSoul]

I have a big problem with dry mouth too. First I got the biotene gum, but it wasn't so great. Then I tried the spray and it worked better but didn't seem to last so long. Finally, I asked my doctor if there was anything else. He prescribed Numoisyn losenges.

They look like little mints, but do not have the taste. Actually, they don't have any taste at all. They do help and it's always easier to carry some around and pop them in your mouth.

I also suggest always having water with you too.

[tojo]

Thanks for the tip wolfsoul I had never heard of those lozenges gonna have to ask the doc next week or the week after cannot remember lol

[mloved]

I got a little of dis and dat.  Lately, when tired and/or not well, I'm not aware that I slur, but it gets pointed out.  During the waking hrs, some drooling has started too, - ain't pretty.

But for yrs, I wake up in the middle of - to find my paper dry tongue stuck hard to somewhere in my paper dry mouth.  Used masking, then duct tape to keep my mouth closed unsuccessfully.  Will try a stretchy head band next, if I can remember.

[foxgrove]

Thanks brother.. Those lozenges sound pretty good.  Gonna talk with my doc about them next visit,