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Persistent hiccups: case report A 15-year-old boy developed persistent hiccups following concomitant administration of aripiprazole and fluoxetine. Additionally, he received methylphenidate which also contributed to the development of persistent hiccups [routes not stated]. The boy had a 7-year history of attention deficit hyperactivity disorder (ADHD) and anxiety disorder. He had been receiving methylphenidate 20 mg/day and fluoxetine 20 mg/day to control his inattentive and anxiety symptoms, respectively. He presented to the hospital due to recurrent emotional outburst since 1 month. He was then diagnosed with major depressive disorder with psychotic feature with comorbidity ADHD and anxiety disorder. His fluoxetine dosage was increased to 40 mg/day with addition of aripiprazole 5 mg/day tablet to alleviate the psychotic symptoms. Therapy with methylphenidate was interrupted in order to prevent aggravating psychotic symptoms. However, he developed continuous hiccups 3h after taking the first tablet of aripiprazole. His hiccups lasted for 48h. The boy’s therapy with aripiprazole was stopped by his parents. His hiccups recovered 6h later. The boy was re-initiated on aripiprazole 2.5 mg/day after 48h of aripiprazole withdrawal, and no recurrence of hiccups was noted. The concomitant administration of aripiprazole and fluoxetine led to increased plasma levels of aripiprazole causing hiccups. Additionally, persistent hyperdopaminergic state due to methylphenidate contributed to hiccups. Author comment: "Lastly, drug-drug interaction between fluoxetine and aripiprazole attribute to hiccups." "Primary, persistent hyperdopaminergic state resulted from methylphenidate may lead to hiccups." Benyakorn S. Aripiprazole-induced persistent hiccups: A case report. Journal of the Medical Association of Thailand 100 (Suppl. 8): S212-S215, No. 10, 2017. Available from: URL: http://www.jmatonline.com/index.php/jmat/article/view/8744 803439756 - Thailand

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Reactions 14 Dec 2019 No. 1783