Clozapine
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Clozapine Hiccups and facial tic: case report A 61-year-old schizophrenic woman started receiving clozapine, which was initiated at 12.5 mg/day and then uptitrated to 500 mg/day over 4 weeks [route not stated]. She subsequently complained of persistent hiccups [time to reaction onset not stated], initially thought to be extrapyramidal symptoms. Her trihexyphenidyl dosage was increased, without much effectiveness. Her clozapine dosing regimen was changed to 3 times daily and her hiccups improved. She received valproic acid and her hiccups totally subsided within a few days. Six months later, she was receiving clozapine and valproic acid with no signs of myoclonus or seizures. [Details of facial tic not stated] Author comment: "Although the exact mechanism by which clozapine can induce hiccups is unknown, the dopaminergic and the GABAergic systems are likely to be implicated." Auclair M, et al. Clozapine-induced hiccups and facial tics in a schizophrenic patient: A case report. Journal of Pharmacy Practice 24: 284-285, No. 2, Apr 2011. Available from: URL: http://dx.doi.org/10.1177/0897190011403437 803070216 Canada
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Reactions 19 May 2012 No. 1402
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