Aripiprazole-induced hiccups: a case report

Ray, Prasenjit Sen; Haq, Mohammad Zia Ul; Nizamie, S. Haque

doi:10.1016/j.genhosppsych.2008.09.014

Cited by 35 publications

(22 citation statements)

References 14 publications

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“…In terms of diverse 5-HT 2A Yantagonist binding affinities (eg, risperidone 9 clozapine 9 aripiprazole X quetiapine), 15 this can explain why quetiapine successfully resolved aripiprazole-induced hiccups in previously reported cases. 4,5 Nevertheless, this could not explain hiccups resolved with risperidone in our case. A partial agonist for aripiprazole at 5-HT 1A receptors might provide a reasonable explanation in the pathophysiology of hiccups because of the relatively high 5-HT 1A receptor binding affinities (aripiprazole X risperidone 9 clozapine 9 quetiapine).…”

Section: Discussionmentioning

confidence: 99%

Persistent Hiccups Associated With Switching From Risperidone to Aripiprazole in a Schizophrenic Patient With Cerebral Palsy

Yeh

2011

Clinical Neuropharmacology

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Antipsychotics are thought to be effective in the treatment of hiccups; however, they are rarely reported to induce hiccups. We report a case of persistent hiccups after administration of aripiprazole in a patient with concurrence of schizophrenia and cerebral palsy. Prior brain injury and switching antipsychotics may precipitate the development of hiccups in the present case. Aripiprazole with a partial agonist of dopamine D2 receptors and serotonin 1A receptors may play a crucial role in the pathophysiology of hiccups.

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Section: Discussionmentioning

confidence: 99%

Persistent Hiccups Associated With Switching From Risperidone to Aripiprazole in a Schizophrenic Patient With Cerebral Palsy

Yeh

2011

Clinical Neuropharmacology

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“…Aripiprazole, a partial agonist at the D 2 , D 3 receptors and 5-HT 1A receptors, is used to stabilize dopamine and serotonin systems through these receptors. A patient was confirmed to manifest hiccup after using this agent because discontinuation was followed by quick symptom resolution within hours 50. Intractable hiccup also subsided after discontinuation of oral azithromycin and intra-thecal morphine administration.…”

Section: Etiology Of Persistent and Intractable Hiccupsmentioning

confidence: 99%

Hiccup: Mystery, Nature and Treatment

Chang¹,

2012

J Neurogastroenterol Motil

167

173

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Hiccup is the sudden onset of erratic diaphragmatic and intercostal muscle contraction and immediately followed by laryngeal closure. The abrupt air rush into lungs elicits a "hic" sound. Hiccup is usually a self-limited disorder; however, when it is prolonged beyond 48 hours, it is considered persistent whereas episodes longer than 2 months are called intractable. A reflex arc involving peripheral phrenic, vagal and sympathetic pathways and central midbrain modulation is likely responsible for hiccup. Accordingly, any irritant in terms of physical/chemical factors, inflammation, neoplasia invading the arc leads to hiccups. The central causes of hiccup include stroke, space occupying lesions and injury etc, whereas peripheral causes include lesions along the arc such as tumors, myocardial ischemia, herpes infection, gastroesophageal reflux disease and applied instrumentations on human body etc. Besides, various drugs (eg, anti-parkinsonism drugs, anesthetic agents, steroids and chemotherapies etc) are the possible etiology. An effective treatment of persistent hiccup may be established upon the correct diagnosis of lesion responsible for the serious event. The pharmacotherapy of hiccup includes chlorpromazine, gabapentin, baclofen, serotonergic agonists, prokinetics and lidocaine. Non-pharmacological approaches such as nerve blockade, pacing, acupuncture and measures to hold breathing are also successful. Finally, alternative medicines and remedies are convenient to treat hiccups with uncertain effect. In conclusions, hiccup is likely to result from lesions involving the hiccup reflex arc. The lesion may need to be localized correctly for ablative treatment in patients with intractable hiccup. Apart from lesion ablation, drugs acting on reflex arc may be effective, while some other conventional measures may also be tried.

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“…Another case was that of a young man who had experienced severe head injury ensuing in behavioral problems that were treated with aripiprazole and carbamazepine. 34 The patient developed hiccup few hours after the first aripiprazole oral administration and after rechallenge; on both occasions, hiccup gradually disappeared after switching the patient to quetiapine. A patient with cerebral palsy developed hiccup after being started on aripiprazole monotherapy to treat hallucinations; hiccup subsided when he was switched back to risperidone.…”

Section: Discussionmentioning

confidence: 52%

“…Despite advancing interactional neurochemical explanations involving the dopaminergic, serotonergic, noradrenergic, and histamine systems, 34,38,39 the literature offers no clues as to why should aripiprazole-BDZ combinations elicit hiccup early in the course of treatment nor why this might be exclusive of the male sex. There are no data regarding the specific midbrain loci involved in the hiccup reflex, but the medulla oblongata and the mesencephalon are 2 suspected regions.…”

Section: Discussionmentioning

confidence: 99%