Medpundit wrote about hiccups today. It reminded me about one of my patients who had protracted hiccups for 5 years – you could only imagine how frustrating this was. He was a 70-yo male who started having hiccups after surgery. Multiple medications were not successful: PPIs, H2 blockers, Thorazine, Reglan, Compazine, Neurontin and Dilantin were given without success. Endless GI and neurology consults were not revealing. There were some small studies using Baclofen for the control of hiccups – and this resulted in mild improvement. However, there continued to be breakthrough episodes. I also read some case reports using Amitriptyline to treat intractible hiccups. Currently, with a regimen of Amitriptyline 100mg at night and Baclofen 10mg 3x/day, it seems like they under adequate control so that the patient can resume a normal life.
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