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Gabapentin results in a reduction in cough frequency and cough severity. It improves cough related quality of life. The effect is greatest in patients with features of central reflex sensitisation such as laryngeal paraesthesia, hypertussia and allotussia. These symptoms can be measured using the Newcastle Laryngeal Hypersensitivity Questionnaire. Introduction Gabapentin, a neurotransmitter modulator, is thought to treat refractory cough associated with interstitial lung disease by improving cough hypersensitivity. Methods/design This is a single-center, prospective, randomized, double-blind, placebo-controlled trial. The trial will investigate the effect of a 10-week course of oral gabapentin 900 mg/day on refractory cough associated Despite recent clinical guidelines, the optimal therapeutic strategy for the management of refractory chronic cough is still a challenge. The present systematic review was designed to assess the evidence for efficacy and safety of gabapentin in the treatment of chronic cough. If chronic cough persists even after treatment of the underlying disease, or if the chronic cough is not attributable to any cause, then a symptomatic approach with neuromodulators may be considered, with gabapentin as the first choice, and opioids or macrolides as alternatives. Gabapentin results in a reduction in cough frequency and cough severity. It improves cough related quality of life. The effect is greatest in patients with features of central reflex sensitisation such as laryngeal paraesthesia, hypertussia and allotussia. Asthma is another common cause of chronic cough, and treatment should begin with patient education on smoking Gibson PG. Gabapentin for refractory chronic cough: a randomised, double-blind The results of prospective case-series showed that the rate of overall improvement of cough and sensory neuropathy with gabapentin was 68%. Gabapentin treatment of patients with chronic cough showed superior efficacy and a good safety record compared with placebo or standard medications. Additional randomized and controlled trials are needed. In The Lancet, Nicole Ryan and colleagues1 report on a placebo-controlled, double-blind trial of the effects of gabapentin—a drug used for epilepsy and neuropathic pain—on quality of life, cough frequency, and cough severity in people with chronic cough. Gabapentin resulted in a significant improvement in cough-specific quality of life, cough severity, and cough frequency and was well tolerated; therefore, it could be considered a viable alternative to current chronic cough treatment, especially for refractory chronic cough. Conclusion: In patients with chronic cough seen in a tertiary care esophageal clinic, low dose gabapentin improved symptoms in a majority of patients, regardless of the results of reflux testing. These results suggest a novel approach to the treatment of chronic cough and merit additional study in a prospective trial. Centrally acting neuromodulators such as amitriptyline, gabapentin, and pregabalin have been shown to improve cough and quality of life in patients with refractory cough.51–54 The effectiveness of these neuromodulators supports the increasingly prominent hypothesis of cough hypersensitivity syndrome in the pathogenesis of chronic cough. Although this is an off-label use, these drugs are thought to lessen the increased neural sensitization that underlies many cases of chronic cough. 16 Currently, there is evidence that amitriptyline, gabapentin, pregabalin, tramadol, and baclofen may benefit chronic cough patients. 18,19 Interpretation: The treatment of refractory chronic cough with gabapentin is both effective and well tolerated. These positive effects suggest that central reflex sensitisation is a relevant mechanism in refractory chronic cough. Given the limited therapeutic options in patients with severe idiopathic chronic cough, it was believed reasonable to try gabapentin because it is well tolerated, has a wide margin of safety, and has no significant drug interactions. 3,4 Gabapentin treatment of patients with chronic cough showed superior efficacy and a good safety record compared with placebo or standard medications. Additional randomized and controlled trials are needed. Gabapentin is effective in the treatment of chronic refractory cough in both subjective and objective evaluations, and its safety is better than other neuromodulators. Keywords: Chronic refractory cough, Gabapentin, Meta-analysis, Efficacy, Safety. 1. Introduction.
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