From the Guidelines
Thorazine (chlorpromazine) can be used to treat intractable hiccups, but its use should be approached with caution due to potential side effects, particularly QTc prolongation, as noted in the study by 1. When considering Thorazine for hiccups, it's essential to weigh the benefits against the risks, especially in patients with pre-existing cardiac conditions or those taking other medications that may prolong the QT interval.
- The study by 1 highlights the importance of monitoring patients receiving antipsychotics, including chlorpromazine, for cardiorespiratory effects and potential QTc prolongation.
- Chlorpromazine has been used to treat nausea, vomiting, and intractable hiccups, as mentioned in the study by 1.
- However, due to its potential side effects, Thorazine is generally reserved for severe, persistent hiccups that significantly impact quality of life or when other treatments have failed.
- Patients should only use Thorazine for hiccups under direct medical supervision, and treatment duration should be short-term until hiccups resolve.
- Before considering Thorazine, patients should try simpler remedies like holding breath, drinking water, or using milder medications such as baclofen or metoclopramide.
- The dose of Thorazine for hiccups is typically 25-50 mg orally three to four times daily, or 25-50 mg intramuscularly for more severe cases, as guided by clinical experience and the study by 1.
From the Research
Thorazine for Hiccups
- Thorazine, also known as chlorpromazine, is a medication that has been used to treat hiccups 2, 3, 4, 5.
- It is the only drug approved by the US Food and Drug Administration for the treatment of hiccups 2.
- Chlorpromazine has been found to be effective in treating hiccups in some cases, but the evidence is limited and there is no clear recommendation for its use as a first-line treatment 4.
- Other medications, such as baclofen, gabapentin, and metoclopramide, have also been used to treat hiccups and may be considered as alternative options 2, 3, 4, 6, 5.
Mechanism of Action
- The exact mechanism of action of chlorpromazine in treating hiccups is not fully understood, but it is thought to involve the inhibition of the hiccup reflex arc 3.
- Chlorpromazine may also have a central effect on the brain, which can help to reduce the frequency and severity of hiccups 3.
Efficacy and Safety
- The efficacy of chlorpromazine in treating hiccups has been reported in several case studies and reviews, but the evidence is largely anecdotal and there is a need for more rigorous clinical trials 2, 4, 5.
- Chlorpromazine is generally well-tolerated, but it can cause side effects such as drowsiness, dry mouth, and blurred vision 5.
- In some cases, chlorpromazine may not be effective in treating hiccups, and other medications or treatments may need to be considered 5.