From the Guidelines
Treatment of Intractable Hiccups
For the treatment of intractable hiccups, olanzapine may be administered at a dose of 5-10 mg orally per day, with a typical duration of treatment ranging from 3 to 14 days 1. Baclofen, on the other hand, is often initiated at a dose of 10-20 mg orally three times a day, with a maximum daily dose of 80 mg and a treatment duration of up to 7-10 days.
- Key considerations for olanzapine include its potential for fatigue, drowsiness, and sleep disturbances, as well as the need for cautious use in elderly patients due to risks such as type II diabetes and hyperglycemia 1.
- In some cases, combination therapy with both olanzapine and baclofen may be considered, with close monitoring of the patient's response and potential side effects.
- It is essential to weigh the benefits and risks of each medication, considering factors such as the patient's medical history, current medications, and potential interactions 1.
- The choice of medication and dosage should be tailored to the individual patient's needs, with ongoing assessment and adjustment as necessary to ensure optimal treatment outcomes.
From the Research
Recommended Dose and Duration of Olanzapine
- The recommended starting dosage of olanzapine is 5-10 mg orally once daily 2, 3
- The maximum recommended dose is 20 mg daily 3
- Efficacy beyond six weeks has not been evaluated, and patients treated for longer than six weeks should be periodically reassessed 2
- The mean daily dose of olanzapine used per patient in a study was 5.49 mg, and the mean duration of treatment was 3.57 days 4
Recommended Dose and Duration of Baclofen
- The dose of baclofen used to treat intractable hiccups was 5-10 mg 3 times daily 5
- Baclofen was titrated down and discontinued after 6 weeks of therapy due to severe central nervous system side effects and lack of efficacy in stopping hiccups 5
- There is no information on the optimal duration of baclofen treatment for intractable hiccups, as it was not effective in the studied case 5
Combination Therapy
- There is no direct evidence on the use of olanzapine and baclofen in combination for treating intractable hiccups 5, 6, 2, 3, 4
- Olanzapine has been studied as a treatment for various psychiatric disorders, including schizophrenia and delirium 2, 3, 4
- Baclofen has been used to treat intractable hiccups, but its efficacy and optimal dosage are not well established 5