Treatment of hiccups in stroke rehabilitation with gabapentin: A case series and focused clinical review

Abstract

Background: Persistent and intractable hiccups have a major impact on quality of life and can be a barrier to stroke rehabilitation. The first-line treatment for intractable hiccups, chlorpromazine, can have sedating effects, which may negatively affect rehabilitation participation. Gabapentin has been reported in several cases to be effective in hiccup treatment in both the general and post-stroke populations.

Objective: To describe the use of gabapentin for treatment of persistent or intractable hiccups in post-stroke patients.

Methods: Four cases were identified by clinicians for a retrospective review. A literature review was concurrently conducted.

Results: This case series presents four patients with improvement or resolution of intractable hiccups on gabapentin in a stroke rehabilitation setting. Therapeutic dose ranged from 100 mg TID to 400 mg BID. Treatment duration ranged from 2 days to 5.5 weeks. Adjuncts were used in three of the cases. A potential side effect was worsened confusion in one case.

Conclusion: Evidence on the use of gabapentin for persistent or intractable hiccups is limited. This case series expands on the current literature by examining and comparing the current literature to our cases and exploring issues related to dosing, titration, side effects, and adjuncts to gabapentin.

Keywords: Stroke; case series; gabapentin; hiccups; stroke rehabilitation.