Baclofen for stroke patients with persistent hiccups: a randomized, double-blind, placebo-controlled trial

Abstract

BackgroundThe results of preclinical studies suggest that baclofen may be useful in the treatment of stroke patients with persistent hiccups. This study was aimed to assess the possible efficacy of baclofen for the treatment of persistent hiccups after stroke.MethodsIn total, 30 stroke patients with persistent hiccups were randomly assigned to receive baclofen (n = 15) or a placebo (n = 15) in a double-blind, parallel-group trial. Participants in the baclofen group received 10 mg baclofen 3 times daily for 5 days. Participants assigned to the placebo group received 10 mg placebo 3 times daily for 5 days. The primary outcome measure was cessation of hiccups. Secondary outcome measures included efficacy in the two groups and adverse events.ResultsAll 30 patients completed the study. The number of patients in whom the hiccups completely stopped was higher in the baclofen group than in the placebo group (relative risk, 7.00; 95% confidence interval, 1.91–25.62; P = 0.003). Furthermore, efficacy was higher in the baclofen group than in the placebo group (P < 0.01). No serious adverse events were documented in either group. One case each of mild transient drowsiness and dizziness was present in the baclofen group.ConclusionsBaclofen was more effective than a placebo for the treatment of persistent hiccups in stroke patients.Trial registrationChinese Clinical Trials Register: ChiCTR-TRC-13004554

Management of hiccups in palliative care patients

“…The result of this study showed that baclofen was more effective than placebo (p=0.003) 13. There were no significant adverse effects, other than one case of each mild transient drowsiness and dizziness.…”

“…A randomised controlled trial by Zhang et al 13 compared baclofen, which is a GABA B (gamma-aminobutyric acid) receptor agonist (10 mg three times a day for 5 days), and placebo for the treatment of persistent hiccups in 30 patients with stroke. The result of this study showed that baclofen was more effective than placebo (p=0.003) 13.…”

Systemic review: the pathogenesis and pharmacological treatment of hiccups

“…fatigue, sedation, dizziness) were not reported by all studies; however, it is clear that these can be associated with all medications with efficacy in hiccups. When reported, the frequency of side effects was up to 50% for neuroleptic medications and this appeared to be more frequent for chlorpromazine and metoclopramide than for baclofen at standard doses or gabapentin . Very little data was available for other medications.…”

“…It has also central and peripheral effects on vagal efferent nerves that inhibit transient relaxations of the lower oesophageal sphincter and diaphragm with effects also on the oesophago‐gastric junction that suppress reflux after meals . Several reports, including one randomised controlled trial, suggest that baclofen can terminate hiccups . Zhang et al .…”

Persistent Hiccups After an Epidural Steroid Injection Successfully Treated With Baclofen: A Case Report

“…Baclofen has been used to treat hiccups in various clinical settings. Zhang et al [6] studied patients with cerebrovascular accident and persistent hiccups and randomized 30 patients to receive baclofen 10 mg 3 times per day or placebo. Hiccups resolved in all but 1 of the patients in the treatment group, and hiccups continued in all but 2 subjects of the placebo group.…”