From the Guidelines
The best treatment for hiccups is chlorpromazine, a phenothiazine that can be used to treat nausea/vomiting and intractable hiccups. According to the study published in Pediatrics 1, chlorpromazine has been used to treat intractable hiccups, suggesting its effectiveness in this condition.
Treatment Options
When considering treatment for hiccups, it's essential to start with simple physical maneuvers, such as:
- Holding your breath for 10-20 seconds
- Drinking a glass of cold water quickly
- Gargling with ice water
- Pulling gently on your tongue
These techniques can interrupt the hiccup reflex by stimulating the vagus nerve or distracting the diaphragm.
Medical Treatment
If hiccups persist, medical treatment may be necessary. Medications that can be effective include:
- Baclofen (5-10 mg three times daily)
- Chlorpromazine (25-50 mg)
- Metoclopramide (10 mg)
These medications work by either reducing nerve impulses to the diaphragm or relaxing the muscles involved in hiccups.
Underlying Medical Conditions
It's crucial to note that persistent hiccups may indicate an underlying medical condition that needs treatment. Most hiccups are caused by irritation of the phrenic or vagus nerves that control the diaphragm, often due to eating too quickly, carbonated beverages, or sudden excitement.
Given the potential risks and benefits of each treatment option, chlorpromazine is the most effective treatment for intractable hiccups, as suggested by the study 1. However, it's essential to consult a healthcare professional to determine the best course of treatment for individual cases.
From the FDA Drug Label
Intractable Hiccups– 25 mg to 50 mg t.i.d. or q.i.d. If symptoms persist for 2 to 3 days, parenteral therapy is indicated. INTRACTABLE HICCUPS If symptoms persist for 2-3 days after trial with oral therapy, give 25 to 50 mg (1-2 mL) IM. Should symptoms persist, use slow IV infusion with patient flat in bed: 25 to 50 mg (1-2 mL) in 500 to 1000 mL of saline.
The best treatment for intractable hiccups is Chlorpromazine. The recommended dosage is 25 mg to 50 mg taken three to four times a day. If symptoms persist for 2 to 3 days, parenteral therapy may be indicated, with a dosage of 25 to 50 mg given intramuscularly or through slow IV infusion 2 3.
From the Research
Treatment Options for Hiccups
- Physical maneuvers that stimulate the uvula or pharynx, or disrupt diaphragmatic rhythm, are often effective in treating benign, self-limited hiccups 4
- For persistent or intractable hiccups, pharmacological treatments such as chlorpromazine, metoclopramide, baclofen, gabapentin, and serotonergic agonists may be used 5, 6, 7
- Non-pharmacological approaches, including nerve blockade, pacing, acupuncture, and measures to hold breathing, have also been found to be successful in treating hiccups 5, 8
- In severe cases, alternative medicines and remedies, as well as surgical interventions such as phrenic nerve crushing or vagus nerve stimulation, may be considered 5, 8
Pharmacological Treatments
- Chlorpromazine is the only drug approved by the US Food and Drug Administration for the treatment of hiccups, but other agents such as baclofen, gabapentin, and metoclopramide have also been found to be effective 4, 6, 7
- The choice of pharmacological treatment should be based on the individual patient's underlying comorbidities, etiology of hiccups, and the properties of the drugs 6
- Baclofen and gabapentin may be considered as first-line therapy for persistent and intractable hiccups, with metoclopramide and chlorpromazine in reserve 7