Gabapentin for intractable hiccup

Hernández, José L.; Pajarón, Marcos; García-Regata, Oscar; Jiménez, Virginia Ortiz Repiso; González‐Macías, Jesús; Ramos-Estébanez, Ciro

doi:10.1016/j.amjmed.2004.03.019

Cited by 45 publications

(18 citation statements)

References 4 publications

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“…A tumor infiltration on the diaphragm was considered as the obvious cause of intractable hiccup 25. A patient with herpes zoster involving cranial nerve neurons including the vagus nerve presented with intractable hiccup and diaphragmatic paralysis; acyclovir treatment effectively ameliorated hiccup in this patient 26.…”

Section: Etiology Of Persistent and Intractable Hiccupsmentioning

confidence: 93%

“…For example, anticonvulsants in various preparations are indicated to treat intractable hiccups. Gabapentin, an alpha-2-delta ligand with structural similarity to GABA and the ability to block voltage-operated calcium channels to reduce release of several neurotransmitters including glutamate and substance P and finally to modulate the diaphragmatic activity, was promising and safe to treat intractable hiccups 25,41,60. Overall, the response rates of gabapentin ranged from 66.7% to 88.4%.…”

Section: Etiology Of Persistent and Intractable Hiccupsmentioning

confidence: 99%

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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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Section: Etiology Of Persistent and Intractable Hiccupsmentioning

confidence: 93%

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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“…Whilst in the UK it is chlorpromazine and haloperidol that are currently licensed for treatment, current literature suggests better outcomes with other medication, in particular gabapentin [44][45][46][47][48] and baclofen [49][50][51][52][53][54]. Porzio et al [55] reported a five year experience in treating palliative patients with IH with gabapentin, reporting an improvement or at least reduction in hiccup frequency in 74.4% of patients treated with 900mg/day and a further 20.93% at 1200mg/ day.…”

Section: Treatmentmentioning

confidence: 99%

Intractable Hiccups Post Stroke: Case Report and Review of the Literature

Ferdinand¹,

Oke²

2012

J Neurol Neurophysiol

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“…A wide range of pharmacologic interventions has been used to treat persistent and intractable hiccups, such as baclofen [13-15], gabapentin [16], chlorpromazine [17], haloperidol [18], and metoclopramide [19]. Several clinical studies have reported that baclofen may help treat persistent hiccups occurring after a stroke [13-15].…”

Section: Introductionmentioning

confidence: 99%

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

Zhang

et al. 2014

Trials

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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

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Gabapentin for intractable hiccup

Cited by 45 publications

References 4 publications

Hiccup: Mystery, Nature and Treatment

Hiccup: Mystery, Nature and Treatment

Intractable Hiccups Post Stroke: Case Report and Review of the Literature

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

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