Sertraline in the Treatment of Hiccups

Vaidya, V.G.

doi:10.1176/appi.psy.41.4.353

Cited by 27 publications

(23 citation statements)

References 9 publications

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“…5-HT is known to be involved in both the anxiety and the neural transmission in the reflex arcs, which are involved in the generation of hiccups [3,9]. Furthermore, recent reports are accumulating evidence that serotonergic agents may ameliorate hiccups [19,20]. These findings, together with our case, indicate that serotonin-acting antipsychotics such as risperidone may be effective in the treatment of some hiccup cases that may involve dysfunctions of the serotonergic systems (e.g., hiccups related to stress or anxiety).…”

Section: Resultsmentioning

confidence: 99%

Intractable hiccups (singultus) abolished by risperidone, but not by haloperidol

2015

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Hiccups or singulata are rhythmic involuntary movements of the diaphragm, caused by a variety of conditions that interfere with the functions of the nerve nuclei in the medulla and supra-spinal hiccup center. Although neurotransmitters and receptors involved in the pathophysiology of hiccups are not defined well, dopamine has been considered to play an important role. In some cases, chlorpromazine or other antipsychotics are used for the treatment of intractable hiccups but their efficacy is often limited. This report involves an 18-year-old patient who experienced two episodes of intractable hiccups triggered by stress, which lasted for weeks or even months. In both episodes, haloperidol was initially used, but there was no significant effect. In contrast, risperidone, the second-generation antipsychotic that possesses a dopamine-serotonin antagonist property, completely abolished the hiccups 6 hours after administration. This is one of few case reports in which two antipsychotics were challenged for a single patient with hiccups, and the effects of the drugs were obviously different. Our finding suggests that, in addition to dopaminergic system, the serotonergic systems may be involved in the pathophysiology of some hiccup cases and that the serotonin-acting antipsychotics such as risperidone should be considered as a choice in the drug treatment of intractable hiccups.

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Section: Resultsmentioning

confidence: 99%

Intractable hiccups (singultus) abolished by risperidone, but not by haloperidol

2015

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“…Anticonvulsants including phenytoin, valproic acid, and carbamazepine have been used for severe hiccups 9) . Case reports of treatment with nimodipine, nifedipine, sertraline, carvedilol, amantadine, and methyphenidate have demonstrated the potential of these medications 7,8,10,19,21) . Finally, reductions in intractable hiccups with intravenous lidocaine, nefopam, amitriptyline, olanzapine have also been reported 1,3,11) .…”

Section: Discussionmentioning

confidence: 99%

Persistent Hiccups after Lumbar Spinal Selective Nerve Root Block

Seo¹,

Hur²,

Choi³

et al. 2017

Asian J Pain

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Hiccups are generally benign and self-limited; however, sometimes they can be persistent and resistant to treatment. Diverse causes of persistent/intractable hiccups have been identified, including medications, a central nervous system pathology, malignancy, and metabolic abnormalities. Neural blocks are a well-known treatment option for chronic lower back pain and are usually indicated in acute and chronic lower back pain. When used in a careful manner with close monitoring, side effects are uncommon and transient; hence, the neural block procedure is considered a safe therapeutic intervention. We present a case of persistent hiccups after a selective nerve root block in a patient with a herniated lumbar disc. A literature review on underlying mechanisms is provided and specific therapies for management are recommended.

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“…[11][12][13][14] Other case reports describe successful use of chlorpromazine, olanzapine, sertraline, nimodipine, amantadine, and midalozam as monotherapy. [15][16][17][18][19][20][21] Several nonpharmacotherapeutic treatment regimens have also been effective, including simple strategies such as nebulized normal saline, 22 the Heimlich maneuver, 23 and sexual intercourse, 24 to more complicated treatments such as acupuncture, [25][26][27][28] nerve stimulation or block, [29][30][31] diaphragmatic pacing, 32 Japanese electro-acustim, 33 and suboccipital release. 34 We were able to find one case report describing cardioversion that successfully treated a patient's intractable hiccups.…”

Section: Discussionmentioning

confidence: 99%

Olanzapine and Baclofen for the Treatment of Intractable Hiccups

2013

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Intractable hiccups are a relatively uncommon condition characterized by involuntary, spasmodic contractions of the diaphragm. This type of hiccups generally has a duration of more than 1 month. We describe a 59-year-old kidney transplant recipient with a complicated medical history (atrial fibrillation, chronic renal failure, type 2 diabetes mellitus, gastroesophageal reflux, gout, hypertension, hyperlipidemia, and obstructive sleep apnea) who developed intractable hiccups that significantly affected his quality of life. Despite an extensive gastrointestinal and pulmonary evaluation, and treatment failures with several different drug regimens--metoclopramide, desipramine, amantadine, cyclobenzaprine, phenytoin, and lorazepam--his hiccups were eventually controlled with a combination of baclofen and low-dose olanzapine therapy. Baclofen is a c-aminobutyric acid (GABA) analog that contains a phenylethylamine moiety. It is hypothesized that having both GABA and phenylethylamine properties activates inhibitory neurotransmitters, most notably GABA, which may in turn block the hiccup stimulus. The exact mechanism through which olanzapine is effective in patients with hiccups is not fully understood. It is thought that the effect is, in part, due to serotonin augmenting phrenic motoneuronal activity on the reflex arcs involved in the generation of hiccups within the spinal cord. In addition, since olanazapine is a dopamine antagonist, particularly a dopamine D₂-receptor antagonist, this could also have played a role in its effectiveness in treating our patient. Strong evidence for a specific treatment regimen for intractable hiccups is lacking in the primary literature. Our case report adds to the available literature, as there are currently no published data on the use of combination therapy for the treatment of intractable hiccups, and the combination of baclofen and olanzapine significantly improved our patient's quality of life.

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Sertraline in the Treatment of Hiccups

Cited by 27 publications

References 9 publications

Intractable hiccups (singultus) abolished by risperidone, but not by haloperidol

Intractable hiccups (singultus) abolished by risperidone, but not by haloperidol

Persistent Hiccups after Lumbar Spinal Selective Nerve Root Block

Olanzapine and Baclofen for the Treatment of Intractable Hiccups

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