From the Guidelines
Chlorpromazine (Thorazine) is effective for treating intractable hiccups, with a recommended dosage of 10-25 mg tid or qid, as per the most recent evidence 1. When considering treatment options for hiccups, it's essential to start with simpler remedies like holding your breath, drinking water quickly, or using medications like baclofen (5-10 mg three times daily) or metoclopramide (10 mg three to four times daily). However, for intractable hiccups, Chlorpromazine can be a viable option.
- The medication works by affecting dopamine receptors in the brain's chemoreceptor trigger zone, which may help interrupt the hiccup reflex arc.
- Treatment duration is usually short-term until hiccups resolve.
- It's crucial to be aware of the potential side effects of Chlorpromazine, including drowsiness, dizziness, dry mouth, and potentially serious movement disorders with prolonged use.
- Medical supervision is essential when using this medication, as it's an antipsychotic with multiple potential adverse effects and drug interactions, as noted in the study on the evaluation and management of children and adolescents with acute mental health or behavioral problems 1.
- The most recent evidence from the study on the management of medically refractory gastroparesis 1 provides guidance on the dosage and use of Chlorpromazine for treating hiccups.
From the Research
Effectiveness of Chlorpromazine for Treating Hiccups
- Chlorpromazine is mentioned as a potential treatment for hiccups in several studies 2, 3, 4, 5.
- According to a systematic review, observational data suggest that chlorpromazine is effective in treating hiccups, although there are no high-quality data to support this claim 2.
- Another study notes that chlorpromazine is the only drug approved by the US Food and Drug Administration for the treatment of hiccups, but there is little evidence to support its use over other agents 3.
- A retrospective study found that chlorpromazine was used to treat hiccups in 17 out of 37 patients, with hiccups disappearing in 32 cases 5.
Comparison with Other Treatments
- Chlorpromazine is often mentioned alongside other treatments, such as metoclopramide, baclofen, and gabapentin, as potential options for treating hiccups 2, 3, 4, 5.
- One study suggests that baclofen and gabapentin may be considered as first-line therapy for persistent and intractable hiccups, with metoclopramide and chlorpromazine in reserve 2.
- Another study notes that prokinetic and neuroleptic agents, including chlorpromazine, are the pillars of treatment for chronic hiccup 5.
Limitations of Current Evidence
- There is a lack of high-quality data to support the use of chlorpromazine for treating hiccups, with most studies being observational or retrospective in nature 2, 3, 4, 5.
- Further research is needed to fully understand the effectiveness and safety of chlorpromazine for treating hiccups, as well as to compare its efficacy with other treatments 2, 3, 6.