The Effect of Gabapentin on the Number and Severity of Cough in the Patients with Resistant Chronic Cough

Document Type : Original Article (s)

Authors

1 Assistant Professor, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Student of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Chronic cough is a diagnostic and therapeutic challenge in today's society. This disease easily affects patients’ quality of life. Recently, the effect of gabapentin on the treatment of a chronic cough has been studied in some researches. This study aimed to evaluate the effect of gabapentin on the number and severity of daily cough in patients with a chronic cough.Methods: In this clinical trial study, 100 patients with chronic cough (more than 8 weeks) and without any specific cause, such as infection, were included. Patients were randomized to receive gabapentin (up to a dose of 900 mg/day) and placebo for up to 4 weeks. The severity of cough was evaluated in patients after 2 and 4 weeks of treatment.Findings: The mean number of attacks per day, the number of coughs per turn, and the visual analog scale (VAS) in the 2nd and 4th weeks after treatment in the group treated with gabapentin was significantly lower than the placebo group (P < 0.05). Moreover, the prevalence of cough with activity and wakefulness due to coughing in the second and fourth weeks was significantly lower in the group treated with gabapentin than in the placebo group (P < 0.05).Conclusion: The initiation of gabapentin treatment up to a maximum of 900 mg per day for 4 weeks reduces symptoms such as waking up from sleep due to coughing or coughing with activity, as well as cough severity and chronic cough attacks.

Keywords


  1. Faruqi S, Murdoch RD, Allum F, Morice AH. On the definition of chronic cough and current treatment pathways: an international qualitative study. Cough 2014; 10: 5.
  2. Holzinger F, Beck S, Dini L, Stoter C, Heintze C. The diagnosis and treatment of acute cough in adults. Dtsch Arztebl Int 2014; 111(20): 356-63.
  3. Irwin RS, Baumann MH, Bolser DC, Boulet LP, Braman SS, Brightling CE, et al. Diagnosis and management of cough executive summary: ACCP evidence-based clinical practice guidelines. Chest 2006; 129(1 Suppl): 1S-23S.
  4. Song WJ, Chang YS, Faruqi S, Kim JY, Kang MG, Kim S, et al. The global epidemiology of chronic cough in adults: A systematic review and meta-analysis. Eur Respir J 2015; 45(5): 1479-81.
  5. Irwin RS. Complications of cough: ACCP evidence-based clinical practice guidelines. Chest 2006; 129(1 Suppl): 54S-8S.
  6. Lahiri KR, Landge AA. Approach to chronic cough. Indian J Pediatr 2014; 81(10): 1027-32.
  7. Padma L. Current drugs for the treatment of dry cough. J Assoc Physicians India 2013; 61(5 Suppl): 9-13.
  8. Chung KF, Pavord ID. Prevalence, pathogenesis, and causes of chronic cough. Lancet 2008; 371(9621): 1364-74.
  9. Chung KF. Approach to chronic cough: the neuropathic basis for cough hypersensitivity syndrome. J Thorac Dis 2014; 6(Suppl 7): S699-S707.
  10. Ternesten-Hasseus E, Larsson C, Larsson S, Millqvist E. Capsaicin sensitivity in patients with chronic cough- results from a cross-sectional study. Cough 2013; 9(1): 5.
  11. Chung KF. Chronic 'cough hypersensitivity syndrome': A more precise label for chronic cough. Pulm Pharmacol Ther 2011; 24(3): 267-71.
  12. Gibson PG, Vertigan AE. Gabapentin in chronic cough. Pulm Pharmacol Ther 2015; 35: 145-8.
  13. Ryan NM, Birring SS, Gibson PG. Gabapentin for refractory chronic cough: a randomised, double-blind, placebo-controlled trial. Lancet 2012; 380(9853): 1583-9.
  14. Bastian RW, Vaidya AM, Delsupehe KG. Sensory neuropathic cough: a common and treatable cause of chronic cough. Otolaryngol Head Neck Surg 2006; 135(1): 17-21.
  15. Jeyakumar A, Brickman TM, Haben M. Effectiveness
  16. of amitriptyline versus cough suppressants in the treatment of chronic cough resulting from postviral vagal neuropathy. Laryngoscope 2006; 116(12): 2108-12.
  17. Sutton KG, Martin DJ, Pinnock RD, Lee K, Scott RH. Gabapentin inhibits high-threshold calcium channel currents in cultured rat dorsal root ganglion neurones. Br J Pharmacol 2002; 135(1): 257-65.
  18. Lee B, Woo P. Chronic cough as a sign of laryngeal sensory neuropathy: Diagnosis and treatment. Ann Otol Rhinol Laryngol 2005; 114(4): 253-7.
  19. Yang JY, Lee WI, Shin WK, Kim CH, Baik SW, Kim KH. Administration of four different doses of gabapentin reduces awakening from breakthrough pain and adverse effects in outpatients with neuropathic pain during the initial titration. Korean J Anesthesiol 2013; 65(1): 48-54.
  20. Van de Kerkhove C, Goeminne PC, Van Bleyenbergh P, Dupont LJ. A cohort description and analysis of the effect of gabapentin on idiopathic cough. Cough 2012; 8(1): 9.
  21. Atreya S, Kumar G, Datta SS. Gabapentin for chronic refractory cancer cough. Indian J Palliat Care 2016; 22(1): 94-6.
  22. Shi G, Shen Q, Zhang C, Ma J, Mohammed A, Zhao H. Efficacy and safety of gabapentin in the treatment of chronic cough: A systematic review. Tuberc Respir Dis (Seoul) 2018; 81(3): 167-74.
  23. Ryan NM. A review on the efficacy and safety of gabapentin in the treatment of chronic cough. Expert Opin Pharmacother 2015; 16(1): 135-45.
  24. Algahtani H, Shirah B. Cough syncope induced by post nasal drip successfully managed by Gabapentin. Respir Med Case Rep 2017; 22: 47-50.