{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T11:28:20Z","timestamp":1761823700126,"version":"build-2065373602"},"reference-count":18,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2014,12,4]],"date-time":"2014-12-04T00:00:00Z","timestamp":1417651200000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2014,12]]},"abstract":"<jats:p>A hiccup is a myoclonic jerk of the diaphragm, and cases of hiccups may last for more than 48\u00a0hours (persistent hiccups) or even more than 2\u00a0months (intractable hiccups). Current pharmacologic treatment of persistent or intractable hiccups mainly includes antidopaminergic drugs. We describe the case of a 60\u2010year\u2010old man with a recent diagnosis of right insular ischemic stroke who presented with frequent, intense, and disabling hiccups for more than 1\u00a0month. As diagnosis of poststroke hiccups was assumed, the patient was treated over the next 6\u00a0months with adequate doses of various antipsychotic drugs commonly used for the treatment of hiccups; however, all were discontinued because of adverse effects. Indeed, dyskinesia after chlorpromazine (up to 75\u00a0mg\/day for 4\u00a0wks), as well as somnolence and dyskinesia after haloperidol (up to 6\u00a0mg\/day for 6\u00a0wks), somnolence after gabapentin (up to 1800\u00a0mg\/day for 8\u00a0wks), and severe somnolence and hypotension after baclofen (up to 50\u00a0mg\/day for 6\u00a0wks) were reported. The patient was then prescribed tetrabenazine at a starting dose of 12.5\u00a0mg twice\/day (25\u00a0mg\/day), with a nearly complete remission of the hiccup symptomatology after ~6\u00a0weeks, when a daily dose of 150\u00a0mg was reached. We therefore hypothesize that a supratentorial lesion may disrupt the modulation of dopaminergic pathways involved in the regulation of medullar centers responsible for the hiccup reflex. To our knowledge, this is the first case report of poststroke hiccups responding to tetrabenazine. The dramatic response of our patient to tetrabenazine monotherapy suggests that this drug may be a valuable pharmacologic alternative for patients with hiccups after stroke who are intolerant or unresponsive to classic antipsychotic agents.<\/jats:p>","DOI":"10.1002\/phar.1523","type":"journal-article","created":{"date-parts":[[2014,12,5]],"date-time":"2014-12-05T06:02:01Z","timestamp":1417759321000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Successful Use of Tetrabenazine in a Patient with Intractable Hiccups After Stroke"],"prefix":"10.1002","volume":"34","author":[{"given":"Antonino","family":"Naro","sequence":"first","affiliation":[{"name":"IRCCS Centro Neurolesi \u201cBonino\u2010Pulejo\u201d Messina Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Placido","family":"Bramanti","sequence":"additional","affiliation":[{"name":"IRCCS Centro Neurolesi \u201cBonino\u2010Pulejo\u201d Messina Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rocco Salvatore","family":"Calabr\u00f2","sequence":"additional","affiliation":[{"name":"IRCCS Centro Neurolesi \u201cBonino\u2010Pulejo\u201d Messina Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,12,4]]},"reference":[{"doi-asserted-by":"publisher","key":"e_1_2_5_2_1","DOI":"10.1097\/00007611-199502000-00002"},{"doi-asserted-by":"publisher","key":"e_1_2_5_3_1","DOI":"10.1016\/j.mehy.2005.08.003"},{"doi-asserted-by":"publisher","key":"e_1_2_5_4_1","DOI":"10.1016\/S1474-4422(09)70183-8"},{"key":"e_1_2_5_5_1","first-page":"173","article-title":"Persistent hiccup","volume":"150","author":"Bailey H","year":"1943","journal-title":"Practitioner"},{"doi-asserted-by":"publisher","key":"e_1_2_5_6_1","DOI":"10.1111\/j.1399-6576.1993.tb03781.x"},{"key":"e_1_2_5_7_1","first-page":"1034","volume-title":"Appleton's dictionary of greater New York and its neighborhood","author":"Osier W","year":"1905"},{"key":"e_1_2_5_8_1","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1183\/09031936.93.06040563","article-title":"Hiccup in adults: an overview","volume":"8","author":"Launois S","year":"1993","journal-title":"Eur Respir J"},{"doi-asserted-by":"publisher","key":"e_1_2_5_9_1","DOI":"10.1007\/s00415-013-6960-9"},{"doi-asserted-by":"publisher","key":"e_1_2_5_10_1","DOI":"10.5056\/jnm.2012.18.2.123"},{"doi-asserted-by":"publisher","key":"e_1_2_5_11_1","DOI":"10.1097\/PHM.0b013e3181152152"},{"doi-asserted-by":"publisher","key":"e_1_2_5_12_1","DOI":"10.1002\/cne.20749"},{"doi-asserted-by":"publisher","key":"e_1_2_5_13_1","DOI":"10.1517\/14656560903386292"},{"key":"e_1_2_5_14_1","first-page":"tre\u201003\u2010191\u20104337","article-title":"Safety and efficacy of tetrabenazine and use of concomitant medications during long\u2010term, open\u2010label treatment of chorea associated with Huntington's and other diseases","volume":"3","author":"Shen V","year":"2013","journal-title":"Tremor Other Hyperkinet Mov (NY)"},{"doi-asserted-by":"publisher","key":"e_1_2_5_15_1","DOI":"10.1038\/nrd2784"},{"doi-asserted-by":"publisher","key":"e_1_2_5_16_1","DOI":"10.1016\/0014-2999(84)90562-4"},{"doi-asserted-by":"publisher","key":"e_1_2_5_17_1","DOI":"10.1002\/j.1875-9114.1996.tb03023.x"},{"doi-asserted-by":"publisher","key":"e_1_2_5_18_1","DOI":"10.1016\/S0140-6736(74)92823-2"},{"doi-asserted-by":"publisher","key":"e_1_2_5_19_1","DOI":"10.1345\/aph.1Q366"}],"container-title":["Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fphar.1523","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/phar.1523","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T14:22:37Z","timestamp":1761056557000},"score":1,"resource":{"primary":{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/10.1002\/phar.1523"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,12]]},"references-count":18,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2014,12]]}},"alternative-id":["10.1002\/phar.1523"],"URL":"https:\/\/doi.org\/10.1002\/phar.1523","archive":["Portico"],"relation":{},"ISSN":["0277-0008","1875-9114"],"issn-type":[{"type":"print","value":"0277-0008"},{"type":"electronic","value":"1875-9114"}],"subject":[],"published":{"date-parts":[[2014,12]]},"assertion":[{"value":"2014-12-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}