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

Abstract

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.

Persistent Hiccups After Switching from Zuclopenthixol to Aripiprazole

“…Aripiprazole DOI: 10.5455/bcp.20120419125722 Persistent hiccups after switching from zuclopenthixol to aripiprazole therapy initiated afterwards may have caused hiccups through agonistic effects on already upregulated D2 receptors (5). Similar to our case, a case of persistent hiccups after switching from risperidone to aripiprazole has been reported (6). Hiccups disappeared in this case after discontinuation of aripiprazole and re-administration of risperidone.…”

The Role of Serotonin in Singultus: A Review

“…In contrast, olanzapine seems to be a successful antipsychotic agent in the context of singultus suppression ( Alderfer and Arciniegas, 2006 ; Rizzo et al, 2014 ). There is an abundance of reports on hiccups associated with aripiprazole treatment ( Behere et al, 2007 ; Ginsberg, 2007 ; Ray et al, 2009 ; De Filippis et al, 2015 ; Sakalli Kani et al, 2015 ; Caloro et al, 2016 ; Kutuk et al, 2016 ) and on persistent hiccups associated with switching antipsychotic treatment from risperidone to aripiprazole ( Yeh, 2011 ), from a typical antipsychotic drug of the thioxanthene class to aripiprazole ( Duvarci and Yilmaz, 2013 ), and from olanzapine to aripiprazole ( Hori and Nakamura, 2014 ). In a patient treated with aripiprazole, singultus persisted, despite trials of metoclopramide and chlorpromazine; remission of hiccups occurred after discontinuation of aripiprazole ( Silverman et al, 2014 ).…”

Aripiprazole-Induced Persistent Hiccup: A Case Report and Review of the Literature

“…However, other additional risk factors have been hypothesized to explain its occurrence. For instance, the association with hyponatremia (Ginsberg 2007 In particular, switching from a D2 high potency blocker to aripiprazole seems to increase the risk of hiccup occurrence, although other mechanisms, involving gabaergic and serotoninergic transmission, are presumably implicated (Yeh 2011, Duvarci & Yilmaz 2013. The importance of the interaction between aripiprazole and benzodiazepine in hiccup occurrence needs to be taken into consideration as well.…”