Amitriptyline for Refractory Idiopathic Intractable Hiccups: A Case Report.

Area of Science:

• Neurology
• Gastroenterology

Background:

• Intractable hiccups, lasting over a month, significantly impact patient quality of life.
• Limited evidence and treatment guidelines make managing refractory hiccups challenging.

Purpose of the Study:

• To present a case of refractory idiopathic intractable hiccups treated with amitriptyline.
• To provide additional evidence for amitriptyline's efficacy in managing intractable hiccups.

Main Methods:

• Case report of a 53-year-old male with refractory idiopathic intractable hiccups.
• Systematic literature review of Medline and PubMed using keywords 'hiccup' or 'singultus' and 'amitriptyline'.
• Analysis of patient's electronic health record and direct care experiences.

Main Results:

• The literature search identified 4 unique cases of intractable hiccups responding to amitriptyline.
• The reported patient experienced improved hiccup relief with the addition of amitriptyline.
• All patients in the reviewed cases had previously tried multiple medications.

Conclusions:

• This study offers new evidence for amitriptyline in intractable hiccup relief, the first in over 30 years.
• Amitriptyline may be particularly beneficial for patients with comorbid mood disorders or suspected psychogenic hiccups.
• Further research is warranted to establish amitriptyline's role in managing intractable hiccups.