Acute Hiccups Following Aripiprazole Treatment in a Patient With Autism Spectrum Disorder and Catatonia: A Detailed Case Report and Management Challenges

Aripiprazole is a widely used second-generation antipsychotic known for its favourable side effect profile. Although generally well-tolerated, rare adverse reactions, such as hiccups, have been documented. We present the case of a 28-year-old male with autism spectrum disorder and psychosis with catatonic features who developed acute, persistent hiccups shortly after starting aripiprazole treatment. The patient, hospitalised for catatonia and psychotic symptoms, was initially treated with benzodiazepines and later with aripiprazole. Within 24 hours of the dose increase to 10 mg/day, he developed continuous hiccups that significantly interfered with oral intake. Aripiprazole was identified as the most likely cause; thus, the medication was discontinued, and chlorpromazine 25 mg twice daily was administered for symptomatic relief. The hiccups completely resolved within 48 hours. This case highlights that hiccups may occur across a range of aripiprazole doses and typically subside after discontinuation. Young male patients with developmental disorders and those concurrently receiving benzodiazepines may be at greater risk. Chlorpromazine may serve as an effective symptomatic option for managing aripiprazole-induced hiccups when benzodiazepine dose reduction is not feasible.

Keywords: Aripiprazole, autism spectrum disorder, catatonia, hiccup