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Neurotin News - Chronic Cough Relief
Neurontin for chronic cough relief
From news8austin.com - July 24, 2004
There are about 30 million visits to the doctor each year for
chronic cough. The three origins of cough are usually post-nasal
drip, when allergies cause secretions in back of the throat;
laryngeal-pharyngeal reflux, when acid from the stomach comes
up and irritates the throat and; asthma or an asthma-like condition.
Most cases of cough are controlled with the clearance of an
upper respiratory tract infection. Previously, chronic cough
and signs of an irritable larynx were considered diseases of
the pulmonary, upper areodigestive tract or were thought to
be psychiatric in nature. Research and treatment were based
on those assumptions. These symptoms will often resolve with
common treatments, such as cough suppressants. However, in a
smaller number of patients, cough persists and becomes a chronic
condition. In about 10 percent to 20 percent of patients, the
origin of their cough remains unknown.
Otolaryngologists Peak Woo, M.D., and Bryant Lee, M.D., from
Mount Sinai Medical Center in New York City, speculate that
symptoms of chronic cough may be a manifestation of sensory
neuropathy -- a disorder of the sensory nervous system. They
studied 28 patients with chronic cough of unknown origin who
had seen several doctors.
"Cough in the throat is much like pain because when the
nerve is irritated, the symptom that it gives you is a sensation
like you're irritated or you need to cough," Lee said.
All patients in the study received gabapentin (Neurontin) --
an anti-seizure medication and neurotransmitter used for pain
syndromes.
"It made sense to us that if you're having a throat that's
irritated or firing uncontrollably, that's triggering cough,
use a seizure medication to suppress the firing of this nerve,"
Lee said.
Patients were instructed to begin at 100 milligrams a day and
increase their dose to 900 milligrams a day in divided doses
over four weeks. Patients added to the dose until symptoms were
resolved or side effects appeared. The rate of overall improvement
of cough and sensory neuropathy using gabapentin was 68 percent.
Responders generally improved within the first few weeks of
therapy, and treatment length varied from three months to four
years depending on symptom control.
Woo said the nerve stays injured just for a period and then
quiets down, so patients are now treated for just three to six
months.
According to Woo, this diagnosis may be an alternate explanation
in some patients who have had a very long history of chronic
cough without explanation or relief.
"To be able to get [patients] a relief for a cough that's
been keeping them up at night or they would wind up in the emergency
room, that's just terrific," Woo said. |
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