title: Development of Hiccup in Male Patients Hospitalized in a Psychiatric Ward: Is it Specifically Related to the Aripiprazole-Benzodiazepine Combination?
abstract: OBJECTIVE
  The aim of this study was to identify hiccup cases among patients hospitalized in a psychiatric ward and focus on their treatment, so to establish intervention risk.
  
  
  METHODS
  We reviewed records of 354 consecutively admitted patients during the year 2013 to identify hiccup cases.
  
  
  RESULTS
  Hiccup occurred in 7 patients on both aripiprazole and benzodiazepines and in one on delorazepam. No patient on aripiprazole alone developed hiccup. No patient on drugs other than aripiprazole or benzodiazepines developed hiccup. The symptom subsided in 3 cases upon discontinuing aripiprazole and in 5 cases after discontinuing the benzodiazepine (including the case on delorazepam alone); in 2 cases of persistent hiccup, the symptom resolved after adding the calcium channel blocker, pregabalin. All patients developing hiccup were male. There was a 70-fold increase in the risk for developing hiccup in the aripiprazole/benzodiazepine intake condition versus all other conditions, and it further increased if limiting to the male sex.
  
  
  CONCLUSIONS
  The retrospective nature of the study was its limitation.
  
  
  CONCLUSIONS
  Hospitalized psychiatric patients on both aripiprazole and benzodiazepines may be at significant risk of hiccup. This clinical awareness could lead to antipsychotic and/or benzodiazepine discontinuation or switch or to the addition of calcium channel blocker inhibitors.
authors.affiliation: *NESMOS Department and UOC Psychiatry, School of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University; and †Clinica Villa von Siebenthal Neuropsychiatric Clinic, Rome, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Caloro
authors.forename: Daniela
authors.initials: D
authors.lastname: Pucci
authors.forename: Giuseppa
authors.initials: G
authors.lastname: Calabrò
authors.forename: Eleonora
authors.initials: E
authors.lastname: de Pisa
authors.forename: Iginia
authors.initials: I
authors.lastname: Mancinelli
authors.forename: Enrico
authors.initials: E
authors.lastname: Rosini
authors.forename: Franco
authors.initials: F
authors.lastname: Montebovi
authors.forename: Sergio
authors.initials: S
authors.lastname: De Filippis
authors.forename: Carla Ludovica
authors.initials: CL
authors.lastname: Telesforo
authors.forename: Ilaria
authors.initials: I
authors.lastname: Cuomo
authors.forename: Georgios D
authors.initials: GD
authors.lastname: Kotzalidis
authors.forename: Paolo
authors.initials: P
authors.lastname: Girardi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014150:Antipsychotic Agents / Q000009:adverse effects*; D000068180:Aripiprazole / Q000009:adverse effects*; D001569:Benzodiazepines / Q000009:adverse effects*; D004359:Drug Therapy, Combination / Q000009:adverse effects; D005260:Female; D006606:Hiccup / Q000139:chemically induced*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy; D008875:Middle Aged; D011567:Psychiatric Department, Hospital; D012727:Sex Characteristics; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D001569:Benzodiazepines; D000068180:Aripiprazole