Amitriptyline for Intractable Hiccups

To the Editor: Several approaches, with varying success rates, have been proposed for the treatment of persistent hiccups.¹ Although treatment with amitriptyline has been proposed,² documentation of its efficacy is scarce. A 17-year-old boy was referred to our clinic because of hiccups that had persisted for a year and that severely impaired his ability to live a normal daily life. Since the age of five, the patient had been treated with insulin for diabetes mellitus and with carbamazepine, methsuximide, and primidone for petit mal epilepsy, which was poorly controlled. The patient's hiccups had been treated with different drugs, including metoclopramide,…