Let's try. 1. As I've already stated, there are no medications brought to market for stuttering. 2. Medications that have been through more extensive trials, such as Ecopipam, have been withdrawn from their attempts to be categorized for fluency. (Pardon me if my terminology here is questionable, I trust everyone follows my meaning.) 3. None of the stuttering associations are promoting or advocating medications. Personally, I think this is huge. I belong to a special needs community not related to stuttering. Off label use of medication is fairly common. Doctors and nurses having established protocols for off label use of particular substances. 4. I'm unaware of any SLP's that are prescribing / referring medication. SLP's are the experts in the field. 5. Fluency can be achieved through learning. Training and practice have been proved to help many people become fluent. ​ >There is evidence showing that it does work and that it is efficacious A Phase 1 trial isn't evidence. It's a non-randomized selection of people to test the safety of a medication in a small group of volunteers. Promising results in a hand-picked group of volunteers is common in phase 1 trials. I look at Ecopipam and I see a drug company searching for an application. They did everything they could, but in the end, the results were that they withdrew their attempts to label the drug for stuttering. ​ >namely because there has not been enough funding to push a medication through for FDA approval for a given indication. Do you have evidence that the problem is funding with regards to FDA approval? ​ Why is it that I hold the opinion that "medical treatment of stuttering" is an inherently flawed concept? Because speech is learned. Stuttering is also learned. I'm not saying we learn it from an outside source. Nor am I saying there aren't biological / neurological contributing factors. In my experience, and that of others, we found small tricks to avoid stuttering. Using "umm", closing our eyes, or other "cheats" to avoid the stutter. And then those cheats became part of our stutter. Our stutter adapted to include the cheat as part of the stutter. Just as we developed a stutter at some point in our speech development or learned new ways to stutter when trying to compensate, we can also learn to speak fluently.