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Hiccups in Parkinson’s disease: an analysis of cases reported in the European pharmacovigilance database and a review of the literature

  • Pharmacoepidemiology and Prescription
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Abstract

Background

Some reports have suggested an association between dopamine agonists and hiccups, involuntary contractions that merit full clinical attention because they can be very debilitating. Many drugs frequently used to treat hiccups are formally contraindicated in Parkinson’s disease due to their liability to worsen motor symptoms, making the treatment of hiccups problematic in this disease. The objective of the present study was to analyze all spontaneous reports of hiccups from the European Pharmacovigilance Database in patients with Parkinson’s disease and/or on dopaminergic drugs. Finally, we sought to identify evidence-based recommendations on the management of hiccups in Parkinson’s disease.

Methods

We searched for all reports of hiccups in the European Pharmacovigilance Database (EudraVigilance) and calculated proportional reporting ratios for dopamine agonists and hiccups. We reviewed the literature on Parkinson’s disease, dopamine agonists, and hiccups, searching for specific treatment recommendations for hiccups in this disease.

Results

Both rotigotine and pramipexole fulfilled the criteria to generate a safety signal. We found 32 and 13 cases of hiccups associated with dopamine agonists in EudraVigilance and the literature, respectively. There were no specific recommendations for the management of hiccups in Parkinson’s disease in the clinical guidelines consulted.

Conclusions

We have found evidence that rotigotine and pramipexole are associated with the appearance of hiccups and that this adverse reaction occurs predominantly in males. Given the scarce information available, specific recommendations are needed in clinical guidelines for the adequate management of hiccups in Parkinson’s disease.

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Authors and Affiliations

  1. Pharmacy Service, Araba Mental Health Network, C/Alava 43, 01006, Vitoria-Gasteiz, Alava, Spain

    U. Lertxundi

  2. Pharmacokinetic, Nanotechnology and Gene Therapy Group (PharmaNanoGene), Faculty of Pharmacy, Lascaray Research Center, University of the Basque Country UPV/EHU, Paseo de la Universidad, 7, 01006, Vitoria-Gasteiz, Spain

    A.C Marquínez, M.Á Solinís, B. Calvo, A. Del Pozo-Rodríguez & A. Isla

  3. Pharmacy Service, Alto Deba Integrated Health Organization, Avda. Nafarroa 16, 20500, Arrasate Gipuzkoa, Spain

    S. Domingo-Echaburu

  4. Basque Pharmacovigilance Unit, Hospital de Galdakao-Usansolo, Galdakao, Spain

    M. García & C. Aguirre

Authors
  1. U. Lertxundi
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  2. A.C Marquínez
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  3. S. Domingo-Echaburu
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  4. M.Á Solinís
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  5. B. Calvo
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  6. A. Del Pozo-Rodríguez
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  7. M. García
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  8. C. Aguirre
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  9. A. Isla
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Contributions

Unax Lertxundi, Ana Marquinez, Saioa Domingo-Echaburu, Maria Angeles Solinis, Ana del Pozo, Begoña Calvo, Montserrat García, and Carmelo Aguirre participated in the conception, manuscript preparation, writing the first draft, and the review and critique of the manuscript. Montserrat Garcia and Carmelo Aguirre searched for hiccup cases in Eudravigilance database.

Corresponding author

Correspondence to U. Lertxundi.

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Financial disclosures

Financial disclosure related to research covered in this article: The Departamento de Salud. Gobierno Vasco provided a grant of 20.300€ to the investigators.

Conflict of interest

The authors declare that they have no conflict of interest.

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Lertxundi, U., Marquínez, A., Domingo-Echaburu, S. et al. Hiccups in Parkinson’s disease: an analysis of cases reported in the European pharmacovigilance database and a review of the literature. Eur J Clin Pharmacol 73, 1159–1164 (2017). https://doi.org/10.1007/s00228-017-2275-6

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  • DOI: https://doi.org/10.1007/s00228-017-2275-6

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