From the Research
For persistent hiccups, baclofen (5-10mg three times daily) is the most effective treatment option, as it has been shown to be successful in treating hiccups with minimal side effects, according to the most recent and highest quality study 1. Hiccups are involuntary contractions of the diaphragm followed by sudden closure of the vocal cords, producing the characteristic "hic" sound. For occasional hiccups, try simple remedies like sipping cold water slowly, holding your breath for 10-20 seconds, breathing into a paper bag for a few minutes, or eating a teaspoon of granulated sugar. Some key points to consider when treating hiccups include:
- Physical maneuvers that may help include pulling your knees to your chest and leaning forward, or gentle pressure on your diaphragm.
- For persistent hiccups (lasting over 48 hours), medical treatment may be necessary, including medications like chlorpromazine (25-50mg orally), baclofen (5-10mg three times daily), or metoclopramide (10mg orally) 2, 3.
- These medications work by either reducing diaphragm irritability or affecting the nerves involved in the hiccup reflex.
- Hiccups occur when your diaphragm becomes irritated or when the vagus or phrenic nerves that control the diaphragm are stimulated, often by eating too quickly, consuming carbonated beverages, or sudden temperature changes 1.
- Most hiccup episodes are brief and harmless, but persistent hiccups may indicate an underlying medical condition requiring evaluation. It's also important to note that the pathophysiology of hiccups and the mechanism by which any of these methods work are unclear, and there is no agreement whether the 'Hic' sound is due to the abrupt closure of the epiglottis or the glottis, including the vocal cords 1. Some studies have investigated the use of other medications, such as gabapentin and chlorpromazine, but the evidence is limited and inconclusive 2, 3. In general, the treatment of hiccups should be individualized and based on the underlying cause and the patient's medical history 2, 3.