Gabapentin "add-on therapy" for idiopathic chronic hiccup (ICH)

The efficacy of cisapride. omeprazole, and baclofen (COB) for treatment of idiopathic chronic hiccup (ICH). was proven in several studies. The combina tion is considered, at present, to be "therapy of choice" for this conditio n. Substituting gabapentin for baclofen in baclofen resistant ICH cases can occasionally be successful. We present here cases where gabapentin was use d successfully in combination with cisapride and omeprazole (COG/one patien t) or as an "add-on" with cisapride, omeprazole, and baclofen (COBG/three p atients). We conclude that, with baclofen and gabapentin, we are in possess ion of two substances that are, as a part of a combination therapy, quite e ffective for ICH. Because of the far more extensive experience with baclofe n, we use it as a first-line therapy, together with omeprazole and cisaprid e. In cases where the results an not entirely satisfactory, the addition of gabapentin should be considered.