CHLORPROMAZINE (THORAZINE) IN THE TREATMENT OF INTRACTABLE HICCUPS

Abstract

Hiccups may be a minor symptom of transient duration or may progress to exhaust the patient's strength and produce marked depression or even death. Many widely divergent causes for hiccups are known, such as diaphragmatic irritation in pleurisy, subphrenic abscess, or retention of toxic products in uremia. When there is no specific cause, the methods of therapy available are of uncertain value in refractory cases. In the past year, 50 patients with intractable hiccups have been treated with chlorpromazine (Thorazine). This agent is a chlorinated phenothiazine and has the following formula: 10-(γ-dimethylaminopropyl)-2-chlorophenothiazine hydrochloride. The group included 46 men and 4 women from 26 to 80 years of age. Symptoms had persisted from days to weeks and had not responded to heavy sedation, carbon dioxide inhalations, or any other therapy including phrenic nerve crush in five cases (table 1). A dose of 50 mg. was given intravenously. This was sufficient to