A MEDLINE search of the National Library of Medicine data base from 1966-1994 was performed to review the anatomy and pathophysiology of intractable hiccups and their nondrug and drug therapies. Pertinent articles were further reviewed for older references and related literature. The infrequent occurrence of intractable hiccups makes it difficult to perform large, well-controlled clinical trials. The only approved drug for the disorder, chlorpromazine, may not be acceptable for every patient. Studies have been conducted with metoclopramide, valproic acid, nifedipine, and baclofen as alternative therapies.