Successful Treatment of Persistent Hiccups with Baclofen and Gabapentin: A case report / 대한마취과학회지

Persistent hiccups are described as a recurring troublesome series of involuntary inspirations accompanied by glottic closure, lasting longer than a month. Recently, baclofen, the most effective treatment for intractable hiccups was found to be a useful drug for the management of chronic hiccups, and that substituting gabapentin for baclofen can be effective. Moreover, gabapentin was used successfully in combination with baclofen. We report here on three patients with persistent hiccups, where gabapentin was used successfully as an "add-on" with baclofen.

Effect of Oral Glycopyrrolate in Essential Hyperhidrosis / 대한마취과학회지

BACKGROUND: Essential hyperhidrosis is a pathologic condition caused by excessive secretion of the eccrine sweat glands. This is an embarrassing condition, which severely reduces the quality of life and may result in psychological disturbance. Our purpose was to determine the therapeutic efficacy of oral glycopyrrolate in term of its strength, safety, and side effects. METHODS: Oral glycopyrrolate was given to 104 patients, 53 men and 51 women with a mean age of 24 years. Patients controlled the dosage of glycopyrrolate for a week. Attention was focused on patient satisfaction, onset time, duration, degree of reducing perspiration and side effects. RESULTS: Ninety eight of 104 patients (94%) were satisfied with their improved condition. The most common maximum dose/day was 2 mg. The overall mean onset time was 2.3 hours and the duration of the effect was 7.4 hours. Dry mouth occurred in 40 patients. Sixty eight of patients (65%) experienced reduced excessive sweating caused by oral glycopyrrolate. CONCLUSIONS: The administration of oral glycopyrrolate is a safe and effective method of treating essential hyperhidrosis, and appears to be an acceptable therapeutic option in any form of hyperhidrosis.

Treatment of Compensatory Gustatory Hyperhidrosis with Topical Glycopyrrolate

Gustatory hyperhidrosis is facial sweating usually associated with the eating of hot spicy food or even smelling this food. Current options of treatment include oral anticholinergic drugs, the topical application of anticholinergics or aluminum chloride, and the injection of botulinum toxin. Thirteen patients have been treated to date with 1.5% or 2% topical glycopyrrolate. All patients had gustatory hyperhidrosis, which interfered with their social activities, after transthroacic endoscopic sympathectomy, and which was associated with compensatory focal hyperhidrosis. After applying topical glycopyrrolate, the subjective effect was excellent (no sweating after eating hot spicy food) in 10 patients (77%), and fair (clearly reduced sweating) in 3 patients (23%). All had reported incidents of being very embrasssed whilst eating hot spicy foods. Adverse effects included a mildly dry mouth and a sore throat in 2 patients (2% glycopyrrolate), a light headache in 1 patient (1.5% glycopyrrolate). The topical application of a glycopyrrolate pad appeared to be safe, efficacious, well tolerated, and a convenient method of treatment for moderate to severe symptoms of gustatory hyperhidrosis in post transthoracic endoscopic sympathectomy or sympathicotomy patients, with few side effects.