How do you approach the management of purposeless groaning/involuntary humming in PSP?

Involuntary and purposeless vocalizations, such as groaning, are commonly observed in Progressive Supranuclear Palsy. They can be intermittent or more continuous in nature, typically not associated with pain, and more bothersome to the caregiver than the patient. SSRIs, such as escitalopram, have been reported in the literature to treat vocalizations in PSP (Quiñones and Seranza, PMID 35203026). Different SSRIs may vary in efficacy for different patients so I would recommend trying another one if the first one was not very beneficial. I have tried sertraline and then escitalopram and found escitalopram to be more beneficial for my patient (had to go up to 15 mg daily).