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Ativan hiccups: Home Remedies, Causes & Symptoms

Содержание

Transient Hiccups Associated with Oral Dexamethasone

Case Rep Dent. 2013; 2013: 426178.

Published online 2013 Oct 9. doi: 10.1155/2013/426178

Author information Article notes Copyright and License information Disclaimer

Hiccups, or singulata (hiccup is singultus), are commonly experienced by most people at one time or another and are usually brief and self-limiting. Although pharmacotherapeutic agents are not generally considered causal in the etiology of hiccups, many clinicians empirically associate episodic hiccups in their patients as being drug induced. The two classes of drugs most often cited as causing hiccups are corticosteroids and benzodiazepines. This report involved a patient who was given preoperative dexamethasone and developed hiccups before anesthesia and surgery commenced. He at no time was in distress, and the surgical procedure was completed without complication. By the second postsurgical day his hiccups were resolved completely. Although the association may be anecdotal, many clinicians consider hiccups a potential side effect of steroid therapy, especially high doses of steroids. Of interest in this case is the relatively low dose of corticosteroid used, albeit apparently linked to his hiccups. Practitioners should be aware of this potential condition.

Hiccups, or singulata (hiccup is singultus), are very common and are experienced by most people at one time or another. They are usually brief and self-limiting but may become prolonged in some patients [1]. Hiccups that linger on for some time may become worrisome to the postoperative patient, thus hindering their nutritional and sleep needs [2, 3].

Hiccups are sudden, uncontrolled contractions of the diaphragm, followed by immediate inspiration and closure of the glottis over the trachea, producing the “hiccup” sound [4]. The classification of hiccups is as follows: up to 48 hours, acute or transient; longer than 48 hours, persistent; and more than a month or two, intractable [5]. The frequency of hiccups in males and females is equivalent, although intractable hiccups occur at a much higher rate in men [6, 7]. The exact etiology of the hiccup is unknown, but the neural process involves the reflex arc consisting of the afferent limb, the center, and the efferent limb [8, 9]. The afferent limb contains the phrenic and vagus nerves together with the sympathetic chain from T6 to T12. The center is linked to the afferent and efferent limbs and occupies a nonspecific location somewhere between C3 and C5. The efferent limb includes the phrenic nerve, accessory respiratory muscles, the glottis, and autonomic processes involving the medullary reticular formation and hypothalamus [4, 10]. One review proposed that the hiccup reflex arc is a myoclonic action and not a true reflex [11].

Medical conditions that have been associated with the development of hiccups include gastrointestinal, neurological, pulmonary, psychogenic, cardiovascular, metabolic, anesthesia related, and drug induced conditions [3, 4, 8, 12, 13]. Using a strict standard, drugs have not been proven to be a common cause of hiccups [7, 14]. Nevertheless, many clinicians have alluded to various medications as triggering the hiccup reflex [1, 3, 6, 13, 15–24]. The following case describes a patient who experienced transient hiccups following oral presurgical administration of dexamethasone.

A 40-year-old male with an unremarkable medical history presented for surgery to place an implant. He was in excellent health, did not take any medications, and was not allergic to any drugs. The patient had taken a single prophylactic dose of 8 mg oral dexamethasone approximately 1 hour earlier. After presurgical vital signs were taken, and before any other medication (sedation, local anesthesia) was administered, the patient developed intermittent bouts of hiccups at a rate of roughly 5 to 7 per minute. He was in no distress and wanted to continue the procedure. Oral triazolam 0.50 mg was given, and by the time the surgery started, the episodic hiccups were reduced greatly allowing the implant to be placed uneventfully. By the time the patient was ready to be escorted from the clinic, the hiccups had returned at about the same rate they occurred preoperatively. He was given postoperative instructions and reassurances and followed up telephonically the next day, where he reported that by late afternoon (32 hours) the rate of hiccup episodes was reduced. The patient’s hiccups resolved completely by 42 hours after he took the dexamethasone. At the 1-week postoperative appointment, the incident was reviewed with the patient and counseling was given on the suspected drug-induced cause of the transient hiccups for his future reference/benefit.

There are few reports in the literature on dexamethasone-induced hiccups and none in the dental literature [6, 15, 18, 23, 24]. Other cases of corticosteroid-induced hiccups have been reported [1, 25], and Dickerman et al. have described the first cases of anabolic steroid-induced hiccups [16, 17]. The only other adverse reaction to steroids found in the dental literature was a case of episodic psychiatric disturbance (cognitive dysfunction) in an 18-year-old female who had taken dexamethasone briefly [26]. The author would be remiss not to mention another suspected dexamethasone-induced transient hiccups case he came across years earlier, but, because other drugs were also given intravenously at the same time, it could not be confirmed.

Corticosteroids and benzodiazepines are the drug groups referenced most frequently in the literature as being associated with hiccups (see the following list), although Thompson and Landry state that there is not sufficient proof that any drug can be considered as definitely causing hiccups [14]. Souadjian and Cain reviewed 220 cases of protracted hiccups and did not mention any medication in the etiology of hiccups [7]. Garvey, who looked at postoperative cases of hiccups, came to the logical conclusion that the etiologic factor was probably drug related [3]; however, she also recounted that the intubation itself may be a contributing factor [27].

Drugs Possibly Associated with Triggering Hiccups:

  • Steroids (dexamethasone, methylprednisolone, oxandrolone, and progesterone)

  • Benzodiazepines (midazolam, lormetazepam, and lorazepam)

  • Barbiturates (methohexital)

  • Antibiotics (azithromycin)

  • Phenothiazines (perphenazine)

  • Opioids (hydrocodone)

  • Alcohol.

The case described here was mild and short term and, even though somewhat inconvenient to the patient, was in practice, clinically insignificant. Hiccups that become persistent or intractable however can interfere with a patient’s daily activities and cause them to seek medical assistance. There are various reports in the literature of different treatments for protracted hiccups, including pharmacologic agents [4, 5, 8, 18, 22, 28–34]. Chlorpromazine is at present the only medication approved by the FDA for the treatment of hiccups, although many practitioners have reported less than desirable results with this drug [6, 17, 29].

Baclofen has been shown to successfully treat chronic hiccups [3, 4, 19, 30, 34], and promising results have been attained with the use of gabapentin alone [31] or as an add-on to combination therapy [5, 32].

The evidence for medication-induced hiccups may be empirical, yet for many the association is strong enough that clinicians should take notice. This is especially true for treatments involving steroids [35], drugs that are commonly used in medicine, including dental medicine. Being able to recognize the potential “drug-hiccup link” will better prepare health care practitioners manage any unexpected complications.

There are many uses for steroids in medicine and dentistry, and clinicians should be attentive to any possible side effects of medications prescribed. This paper and case explain the correlation between hiccups and steroid treatment in the perioperative setting. Although drug-induced hiccups have not been absolutely confirmed with controlled studies, the incidence is sufficient enough to raise questions by many practitioners. Fortunately, most cases of corticosteroid-related hiccups appear to be transient and usually end after the drug is withdrawn.

The authors declare that they have no conflict of interests.

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Ativan and Hiccups, a phase IV clinical study of FDA data

Hiccups is found among people who take Ativan, especially for people who are male, 60+ old.

The phase IV clinical study analyzes which people take Ativan and have Hiccups. It is created by eHealthMe based on reports of 68,551 people who have side effects when taking Ativan from the FDA, and is updated regularly. You can use the study as a second opinion to make health care decisions.

Phase IV trials are used to detect adverse drug outcomes and monitor drug effectiveness in the real world. With medical big data and AI algorithms, eHealthMe is running millions of phase IV trials and makes the results available to the public. Our original studies have been referenced on 600+ medical publications including The Lancet, Mayo Clinic Proceedings, and Nature.



On May, 24, 2023

68,551 people reported to have side effects when taking Ativan.
Among them, 81 people (0.12%) have Hiccups.


What is Ativan?

Ativan has active ingredients of lorazepam. It is often used in stress and anxiety. eHealthMe is studying from 72,622 Ativan users for its effectiveness, alternative drugs and more.

What is Hiccups?

Hiccups (an involuntary spasm of the diaphragm and respiratory organs, with a sudden closure of the glottis and a sound like a cough) is found to be associated with 1,713 drugs and 1,153 conditions by eHealthMe.

Number of Ativan and Hiccups reports submitted per year:


Gender of people who have Hiccups when taking Ativan *:

  • female: 14.29 %
  • male: 85.71 %

Age of people who have Hiccups when taking Ativan *:

  • 0-1: 0.0 %
  • 2-9: 0.0 %
  • 10-19: 4.76 %
  • 20-29: 0.0 %
  • 30-39: 3.17 %
  • 40-49: 7.94 %
  • 50-59: 12.7 %
  • 60+: 71. 43 %

Common drugs people take besides Ativan *:

  1. Lipitor: 27 people, 33.33%
  2. Prilosec: 23 people, 28.40%
  3. Zometa: 21 people, 25.93%
  4. Protonix: 21 people, 25.93%
  5. Demerol: 21 people, 25.93%
  6. Reglan: 20 people, 24.69%
  7. Lasix: 20 people, 24.69%
  8. Coumadin: 19 people, 23.46%
  9. Nexium: 19 people, 23.46%
  10. Norvasc: 19 people, 23.46%

Common side effects people have besides Hiccups *:

  1. Nausea (feeling of having an urge to vomit): 41 people, 50.62%
  2. Headache (pain in head): 27 people, 33.33%
  3. Breathing Difficulty: 27 people, 33.33%
  4. Drowsiness: 26 people, 32. 10%
  5. Pain: 26 people, 32.10%
  6. Chest Pain: 25 people, 30.86%
  7. Abdominal Pain Upper: 23 people, 28.40%
  8. Emotional Distress: 22 people, 27.16%
  9. Nausea And Vomiting: 22 people, 27.16%
  10. Abdominal Pain: 22 people, 27.16%

Common conditions people have *:

  1. Multiple Myeloma (cancer of the plasma cells): 23 people, 28.40%
  2. Trismus (reduced opening of the jaws): 17 people, 20.99%
  3. Nausea (feeling of having an urge to vomit): 10 people, 12.35%
  4. Pancreatic Carcinoma (pancreatic cancer): 9 people, 11.11%
  5. Diabetes: 9 people, 11.11%
  6. Diarrhea: 9 people, 11.11%
  7. Fever: 9 people, 11.11%
  8. Infection: 9 people, 11. 11%
  9. 17-Hydroxyprogesterone Increased: 8 people, 9.88%
  10. Pain: 4 people, 4.94%

* Approximation only. Some reports may have incomplete information.

Do you take Ativan and have Hiccups?

Check whether Hiccups is associated with a drug or a condition


How to use the study?

You can discuss the study with your doctor, to ensure that all drug risks and benefits are fully discussed and understood.



Related studies

How severe was Hiccups and when was it recovered:
  • Hiccups in Ativan
Expand to all the drugs that have ingredients of

lorazepam:

  • Hiccups and drugs with ingredients of lorazepam (191 reports)
Alternative drugs to, pros and cons of Ativan:
  • Ativan (72,622 reports)
Common Ativan side effects:
  • Fatigue (feeling of tiredness): 7,778 reports
  • Stress and anxiety: 6,626 reports
  • Pain: 6,016 reports
  • Weakness: 5,038 reports
  • Breathing difficulty: 4,990 reports
  • Diarrhea: 4,974 reports
Browse all side effects of Ativan:

abcdefghijklmnopqrstuvwxyz

Hiccups treatments and more:
  • Hiccups (9,305 reports)
COVID vaccines that are related to Hiccups:
  • Hiccups in Moderna COVID Vaccine
  • Hiccups in Pfizer BioNTech Covid Vaccine
  • Hiccups in Johnson and Johnson Covid Vaccine
Common drugs associated with Hiccups:
  • Revlimid: 448 reports
  • Aspirin: 432 reports
  • Nicorette: 403 reports
  • Commit: 313 reports
  • Omeprazole: 284 reports
  • Metformin: 256 reports
  • Fluorouracil: 247 reports
  • Dexamethasone: 230 reports
  • Nicotine polacrilex: 215 reports
  • Cisplatin: 208 reports
All the drugs that are associated with Hiccups:
  • Hiccups (1,713 drugs)
Common conditions associated with Hiccups:
  • Multiple myeloma: 598 reports
  • High blood pressure: 360 reports
  • Quit smoking: 299 reports
  • Pain: 238 reports
  • Type 2 diabetes: 233 reports
  • Multiple sclerosis: 223 reports
  • Diabetes: 185 reports
All the conditions that are associated with Hiccups:
  • Hiccups (1,153 conditions)

How the study uses the data?

The study uses data from the FDA. It is based on lorazepam (the active ingredients of Ativan) and Ativan (the brand name). Other drugs that have the same active ingredients (e.g. generic drugs) are not considered. Dosage of drugs is not considered in the study.

Who is eHealthMe?

With medical big data and proven AI algorithms, eHealthMe provides a platform for everyone to run phase IV clinical trials. We study millions of patients and 5,000 more each day. Results of our real-world drug study have been referenced on 600+ medical publications, including The Lancet, Mayo Clinic Proceedings, and Nature. Our analysis results are available to researchers, health care professionals, patients (testimonials), and software developers (open API).

WARNING, DISCLAIMER, USE FOR PUBLICATION

WARNING: Please DO NOT STOP MEDICATIONS without first consulting a physician since doing so could be hazardous to your health.

DISCLAIMER: All material available on eHealthMe. com is for informational purposes only, and is not a substitute for medical advice, diagnosis, or treatment provided by a qualified healthcare provider. All information is observation-only. Our phase IV clinical studies alone cannot establish cause-effect relationship. Different individuals may respond to medication in different ways. Every effort has been made to ensure that all information is accurate, up-to-date, and complete, but no guarantee is made to that effect. The use of the eHealthMe site and its content is at your own risk.

If you use this eHealthMe study on publication, please acknowledge it with a citation: study title, URL, accessed date.

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How to get rid of hiccups quickly and easily

Likbez

Health

June 1, 2020

Eat a lemon, have sex, or breathe into a bag.

Where does hiccups come from

Hiccups are involuntary contractions of the diaphragm, the muscle that separates the chest from the abdomen and plays a vital role in breathing.

The movements of the diaphragm are controlled by the brain. Sometimes he gives incorrect signals, causing her to contract faster than necessary. With each spasm, the muscle presses on the lungs and pushes air out of them. It passes under pressure through the larynx and closes the glottis and epiglottis. This process is accompanied by a characteristic sound. Spasms are repeated, hiccups occur.

Physiologists do not always understand what exactly causes diaphragmatic contractions. There are many possible reasons: from accidental swallowing of air to dangerous diseases of the nervous system.

Robert Provine

neuroscientist, author of Curious Behavior: Yawning, Laughing, Hiccups, commentary to Vox

We still don’t really know where hiccups come from. Therefore, her therapy has not improved since the time of Plato.

However, whatever causes hiccups can be stopped with simple methods.

Reading now 🔥

  • What to do if the temperature persists at 37 ° C

How to get rid of hiccups

Most ways to quickly stop respiratory spasms have one of two goals: measure the concentration of carbon dioxide in the lungs and blood. Feeling the threat of suffocation, the body quickly recovers and normalizes the work of the diaphragm.

  • Stimulate the vagus nerve. It links the brain and the digestive system and is also involved in the process of respiration. Stimulation causes the brain to switch to new sensations and stop transmitting incorrect signals to the diaphragm.
  • Choose any option you like. And move on to another if the previous one didn’t work.

    Hold your breath

    Take a deep breath and hold it for 10-20 seconds. Then exhale slowly. Repeat if necessary.

    Breathe into a paper bag

    Take a small paper (not plastic!) bag and cover your nose and mouth with it. Slowly exhale and inhale so that the bag inflates and deflates. Continue for 15 seconds.

    Breathe slowly.

    Inhale deeply, counting to five, and exhale in the same way. Do 5-7 reps.

    Embrace your knees

    Find a place where you can sit comfortably and raise your knees to chest height. Grasp your legs with your hands and try to press them more tightly to the body, while leaning forward. Sit in this position for 20-30 seconds.

    Drink a glass of cold water

    Do it quickly. To stimulate the vagus nerve even more effectively, you can drink through a straw, plugging your ears with your fingers, pressing on your closed eyes, or squeezing the wings of your nose.

    Suck on an ice cube

    Suck it on for a few minutes. And swallow when it shrinks to a small size.

    Eat something with a strong taste

    For example, a slice of lemon or a tomato seasoned generously with vinegar.

    Try to induce a gag reflex

    This can be done by pressing your fingers or a spoon on the base (root) of the tongue. The inevitable spasm of the esophagus will stop the contractions of the diaphragm.

    Stick out your tongue as far as you can

    To be sure, pull it out and down with your fingers. This will also put pressure on the root of the tongue and provoke a spasm of the esophagus.

    Put sugar on the tongue

    Approximately a teaspoon, trying to place the crystals as close as possible to the root of the tongue. Let the sand dissolve or do not swallow for at least 5-10 seconds.

    Inhale something with a strong smell

    Ammonia or ammonia will do.

    Massage the carotid artery

    It runs on both sides of the neck. This is the paired artery that you press with your fingers when you try to feel for a pulse under the lower jaw.

    Lie on your back, turn your head to the left and massage the artery on the right side in a circular motion for 5-10 seconds.

    Do a rectal massage

    Simply place your finger in the anus. This non-standard method was discovered by doctors at the Bnei Zion Medical Center (Haifa, Israel). This is how they stopped the persistent hiccups in a 60-year-old patient.

    In 2006, doctors even received the Ig Nobel Prize for their discovery.

    Have sex

    Francis Fesmire, the physician who published the first study on the benefits of rectal massage, later said that he would have advised sex instead of a finger in the anus.

    Francis M. Fesmire

    emergency medicine specialist, commenting to the New Scientist

    Orgasm results in incredible stimulation of the vagus nerve. From now on, I will recommend sex as a cure for intractable hiccups.

    Get distracted

    Often, to get rid of hiccups, it is enough to stop concentrating on it. Take a Chinese or English lesson online, complete a crossword puzzle, or try mentally calculating 112 ÷ 4 × 2.5.

    What to do if you can’t stop hiccuping

    Attacks of diaphragmatic contraction usually last a few minutes and are not dangerous. But if you have hiccups for more than 48 hours in a row or cramps cause problems with eating, sleeping, breathing, see a therapist as soon as possible. Such hiccups are a sign of serious illness. Only a doctor can diagnose them.

    This article was first published in September 2016. In June 2020, we updated the text.

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    Myths and science: how to beat hiccups?

    • Claudia Hammond
    • BBC Fututre

    Image copyright Thinkstock

    Caption before photo,

    Stick out tongue as strong as possible – this also often helps

    Hold your breath or try something more exotic and rough? BBC Future’s correspondent talks about how to stop hiccups on your own and why these methods work.

    As soon as someone starts hiccuping, everyone vies with each other to start frightening the unfortunate person, suggesting that he hold his breath and giving a lot of other advice. What ways to beat hiccups are supported by scientific evidence?

    Hiccups are a consequence of diaphragmatic spasm, causing air to flow into the lungs, which in turn causes a sharp closure of the vocal cords with a characteristic “hic” sound. There are more than a hundred causes of hiccups – in most cases quite harmless. For example, it may be related to taking medications – hiccups can provoke some anesthetics and steroid drugs, drugs prescribed for Parkinson’s disease, as well as chemotherapy drugs used to treat cancer. But, as a rule, this is not the case. Laughter, alcohol abuse, hasty swallowing of food or carbonated drinks can also lead to hiccups – and sometimes it even occurs on its own, without any reason.

    Not without extremes. It is believed that the world record for the duration of hiccups belongs to an American named Charles Osborne: he had an attack of hiccups in 1922 (according to reports, at that moment he was trying to weigh a pig), and stopped only 68 years later – in February 1990.

    Fortunately, hiccups can usually be stopped by simpler methods – although the debate over which of them is most effective has not subsided yet.

    The bulk of folk remedies affect one of two mechanisms. The first group includes methods aimed at increasing the level of carbon dioxide in the blood, which is designed to relieve spasm of the diaphragm, such as holding the breath or breathing through a paper bag.

    Sometimes these methods are effective, but scientists still do not really understand what they work. Some believe that this allows you to switch attention to the problem of increasing the concentration of carbon dioxide, while others suggest that it is the lack of this gas that is one of the causes of hiccups, so its replenishment allows you to stop the attack.

    An alternative way to combat hiccups is to stimulate the vagus nerve, which connects the head to the abdomen and is responsible for coordinating breathing and swallowing. This nerve is involved in the process of hiccups, which can be interrupted by a certain impact on the nerve, as a result of which it begins to send signals to the brain about the appearance of a new sensation.

    This group includes advice to drink water, chew on a lemon, or fill your mouth with crushed ice. To stimulate the vagus nerve, you can also stick out your tongue, put your fingers in your ears, or apply light pressure on your eyeballs. In essence, this is an attempt to distract the body from hiccups by turning attention to some unexpected event. Attempts to stop hiccups by frightening the sufferer are based on the same logic.

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    There are some radical remedies for hiccups that are not suitable for home use. Or just the opposite?

    There is another radical remedy, which, perhaps, is not suitable for home use. It was introduced by Francis Fesmire, a professor at the Faculty of Medicine at the University of Tennessee (USA). The essence of the method is clear from the title of his scientific work, published in 1988 – “Cessation of intractable hiccups by rectal massage.”

    It all started when a man came to the emergency room with a complaint of hiccups that lasted for three days at two second intervals. The doctor forced the patient to open his mouth wide, pressed his eyeballs, but nothing helped. After trying every means, Fesmire recalled reading last year about how a doctor managed to stop a fast heartbeat in a 71-year-old woman by inserting a finger into her anus. This remedy also helped the hiccuping patient.

    However, after receiving a parody Ig Nobel Prize for his discovery, Fesmire stated that the same effect could most likely be achieved through orgasm, and most patients would certainly prefer this method. Both of these approaches also aim to stimulate the vagus nerve.

    Most folk remedies for getting rid of hiccups really do not have scientific evidence.