title: Low-dose gabapentin for intractable hiccups in a heart transplant recipient.
abstract: Intractable hiccups can be a serious complication in transplant recipients. Unfortunately, many of the pharmacotherapies used to stop hiccups are associated with severe side effects as well as drug-drug interactions with immunosuppressants. We report a case of a heart transplant recipient who had had intractable hiccups for 2 months, resulting in severe insomnia, diminished appetite, and weight loss. To treat the hiccups, treatment with oral baclofen (5-10 mg 3 times daily) was started. After 6 weeks of therapy, the baclofen was titrated down and discontinued because it had not stopped the hiccups and was causing severe central nervous system side effects. Gabapentin (100 mg twice daily) was then prescribed and within 24 hours of the start of that treatment, the hiccups had resolved completely. After 3 weeks of therapy, the patient had no side effects and the gabapentin was subsequently discontinued. One year after stopping the gabapentin, the patient remains free of hiccups. Gabapentin appears to be a promising medication for the treatment of intractable hiccups in thoracic transplant recipients because of its lack of serious side effects at low doses, rapid onset of action, and lack of drug-drug interactions with transplant medications.
authors.affiliation: University of Colorado, School of Pharmacy, Aurora, CO 80045, USA. robert.page@ucdenver.edu
authors.forename: Robert L
authors.initials: RL
authors.lastname: Page
authors.forename: Megan
authors.initials: M
authors.lastname: Luna
authors.forename: Andreas
authors.initials: A
authors.lastname: Brieke
authors.forename: Joann
authors.initials: J
authors.lastname: Lindenfeld
mesh_terms: D000328:Adult; D000588:Amines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002121:Calcium Channel Blockers / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D003509:Cyclohexanecarboxylic Acids / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000077206:Gabapentin; D016027:Heart Transplantation / Q000009:adverse effects*; D006606:Hiccup / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D008297:Male; D005680:gamma-Aminobutyric Acid / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D000588:Amines; D002121:Calcium Channel Blockers; D003509:Cyclohexanecarboxylic Acids; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin