Baclofen for stroke patients with persistent hiccups: a randomized, double-blind, placebo-controlled trial.

Cuie Zhang,Ruifen Zhang,Shuangyan Zhang,Meiling Xu,Shuyan Zhang

doi:10.1186/1745-6215-15-295

Cuie Zhang, Ruifen Zhang + Show 3 more

Open Access

https://doi.org/10.1186/1745-6215-15-295

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Abstract

BackgroundThe results of preclinical studies suggest that baclofen may be useful in the treatment of stroke patients with persistent hiccups. This study was aimed to assess the possible efficacy of baclofen for the treatment of persistent hiccups after stroke.MethodsIn total, 30 stroke patients with persistent hiccups were randomly assigned to receive baclofen (n = 15) or a placebo (n = 15) in a double-blind, parallel-group trial. Participants in the baclofen group received 10 mg baclofen 3 times daily for 5 days. Participants assigned to the placebo group received 10 mg placebo 3 times daily for 5 days. The primary outcome measure was cessation of hiccups. Secondary outcome measures included efficacy in the two groups and adverse events.ResultsAll 30 patients completed the study. The number of patients in whom the hiccups completely stopped was higher in the baclofen group than in the placebo group (relative risk, 7.00; 95% confidence interval, 1.91–25.62; P = 0.003). Furthermore, efficacy was higher in the baclofen group than in the placebo group (P < 0.01). No serious adverse events were documented in either group. One case each of mild transient drowsiness and dizziness was present in the baclofen group.ConclusionsBaclofen was more effective than a placebo for the treatment of persistent hiccups in stroke patients.Trial registrationChinese Clinical Trials Register: ChiCTR-TRC-13004554

Highlights

The results of preclinical studies suggest that baclofen may be useful in the treatment of stroke patients with persistent hiccups
Eligible participants were randomly allocated to the baclofen group or the placebo group at a 1:1 allocation ratio and received treatment for 5 days, with 15 days of follow-up
One participant in the baclofen group showed improvement in persistent hiccups, compared with five patients in the placebo group (RR, 0.20; 95% confidence interval (CI), 0.03–1.51; P = 0.12)

Summary

Introduction

The results of preclinical studies suggest that baclofen may be useful in the treatment of stroke patients with persistent hiccups. This study was aimed to assess the possible efficacy of baclofen for the treatment of persistent hiccups after stroke. Hiccups are caused by involuntary multiple spastic contractions of the diaphragm and intercostal muscles. This action is rapidly accompanied with uncontrollable inhalation and a sudden closure of the respiratory tract by the epiglottis, resulting in the classic “hic” sound [1,2]. Hiccups are classified under three categories depending on their duration: acute, persistent, and Stroke patients experience a variety of symptoms and complications that can significantly impair their quality of life. Some of the most commonly encountered complications in clinical practice include pressure ulcers [6,7,8], depression [9], motor disability [10], insomnia [11], and hiccups [12]

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