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Persistent Hiccups after Switching from Zuclopenthixol to Aripiprazole

Transient hiccup is a common problem, usually resolves spontaneously and does not present a clinical issue. The clinical issue arises in the case of persistent (>2 days) and intractable (>1 month) hiccups which are uncommon but associated with considerable discomfort. Hiccups can arise from organic, idiopathic and psychogenic causes. The use of therapeutic drugs forms one of the important causes of hiccups. Antipsychotics are thought to be effective in the treatment of hiccups. Although the exact pathophysiological processes involved have not yet been established, the neurotransmitters dopamine, serotonin and gamma amino butyric aid (GABA) have been documented to play a significant role in the generation of hiccups. We report a patient of 66 year-old male with late-onset schizphrenia who developed persistent hiccups with switching from zuclopenthixol to the atypical antipsychotic aripiprazole . We discuss the possible underlying neurotransmitter mechanisms and the clinical implications of this rare adverse event.