Medical Are these journals reliable? (Elimination of hiccups after chemotherapy)

[Wrichik Basu]

Some of you here may know from one of my earlier profile posts that my father has been diagnosed with stage 4 metastatic lung adenocarcinoma. He is receiving chemotherapy, the exact drugs being Pemetrexed, Carboplatin and bevacizumab.

After his first chemo cycle, he started having hiccups, but they stopped after taking one tablet of Baclofen 10 mg. Today, he came home after his 2nd cycle, but the hiccups are no longer stopping with baclofen. Our family physician (who is a senior doctor with a degree in internal medicine), after speaking to our oncologist, increased the dose of baclofen 10 mg to three times per day. Don't know whether that will work, but Dad is suffering quite a lot from the hiccups.

I was searching on Google to find a remedy for the hiccups. Several papers stated that dexamethasone, which is given for prevention of chemotherapy-induced nausea and vomiting (CINV), is possibly the cause of the persistent hiccups. These are the papers:

• Severe hiccups during chemotherapy: corticosteroids the likely culprit
• Cisplatin-Related Hiccups: Male Predominance, Induction by Dexamethasone, and Protection Against Nausea and Vomiting
• https://doi.org/10.12659/AJCR.915282

The first of these states, in its abstract, that elimination of dexamethasone stopped the hiccups, and did not have any impact on CINV. The second states the same, except that there was a decrease in protection against CINV after withholding dexamethasone in the next cycle of chemo.

After searching some more, I found the following papers that state that changing dexamethasone to methylprednisolone decreases the intensity of hiccups by a large extent, and, in some cases, eliminates hiccups.

• Corticosteroid rotation to alleviate dexamethasone-induced hiccup: a case series at a single institution
• Treatment of dexamethasone-induced hiccup in chemotherapy patients by methylprednisolone rotation
• Antiemetic Corticosteroid Rotation from Dexamethasone to Methylprednisolone to Prevent Dexamethasone-Induced Hiccup in Cancer Patients Treated with Chemotherapy: A Randomized, Single-Blind, Crossover Phase III Trial

I am not asking for medical advice here. I am not asking whether the doctor should actually switch to methylprednisolone because that will be decided by the doctor himself. But, I am thinking of sending these articles to him and then requesting him to explore the possibility of replacing dexamethasone. This is where I need your help: I have absolutely no idea about journals in medical science. Are the journals (where the above papers are published) reliable? I found all of these papers via PubMed, by the way.

 

[BillTre]

Sorry to hear about our Dad.

I don't know anything about those journals.
The more specialized a journal is, the less it is know to those outside of its particular field.

You might get a wider understanding of hiccups from articles like this:
Here is a General overview of hiccups.
It discusses the neural reflex circuit that gets activated to generate the hiccup behavior, some anatomy, various ways the behavior might be affected, pharmacology, and possible treatments.

 

[berkeman]

Our family physician (who is a senior doctor with a degree in internal medicine), after speaking to our oncologist, increased the dose of baclofen 10 mg to three times per day. Don't know whether that will work, but Dad is suffering quite a lot from the hiccups.

Regardless of the quality of the journals in this case, I would not recommend doing anything outside of the treatment recommendations and Rx given by the doctors who are familar with your father's case. It would be too easy to do something that could cause side-effects or compromise the efficacy of your father's treatment. Just keep the doctors in the loop for how the hiccups are responding to their treatments, and keep asking for them to improve the situation. I hope things get better soon.

 

[Wrichik Basu]

I would not recommend doing anything outside of the treatment recommendations and Rx given by the doctors who are familar with your father's case. It would be too easy to do something that could cause side-effects or compromise the efficacy of your father's treatment.

Absolutely. What I am saying is that I will just discuss this with the oncologist. As far as I have seen him, he is an amicable person and does not have a problem in discussing things with the patient's family. Until and unless he gives a nod, we obviously cannot give Dad anything outside the prescription.