dextromethorphan and Sleep-Wake-Disorders

Cough causes concern for parents and is a major cause of outpatient visits. It can impact on quality of life, cause anxiety and affect sleep in parents and children. Several remedies, including honey, have been used to alleviate cough symptoms.. To evaluate the effectiveness of honey for acute cough in children in ambulatory settings.. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2009, issue 2) which contains the Cochrane Acute Respiratory Infections Group's Specialised Register; MEDLINE (1950 to April Week 2 2009); EMBASE (1990 to April 2009); CINAHL (1982 to April 2009); Web of Science (2000 to April 2009); AMED (1985 to April 2009); and LILACS (1982 to April 2009).. Randomised controlled trials (RCT) comparing honey given alone or in combination with antibiotics versus nothing, placebo or other over-the-counter (OTC) cough medications to participants aged from two to 18 years for acute cough in ambulatory settings.. Two review authors independently screened search results for eligible studies and extracted data on reported outcomes. Trial authors of the included study were contacted for additional information on unpublished data.. One RCT of 108 children with upper respiratory tract infections comparing the effect of honey, dextromethorphan and no treatment on cough and sleep quality for coughing children and their parents was included. Comparing symptoms and sleep quality scores of children that received honey with those that received no treatment showed that honey was more effective in reducing frequency of cough (mean difference (MD) -0.99; 95% CI -1.63 to -0.35, bothersome cough (MD -0.93; 95% CI -1.76 to -0.10), and sleep quality of the child (MD -0.92; 95% CI -1.77 to -0.07); but did not differ significantly between the honey versus no treatment groups in resolving severity of cough (MD -0.69; 95% CI -1.46 to 0.07) and sleep quality of the parents (MD 0.80; 95% CI -1.67 to 0.07). Dextromethorphan and honey did not differ significantly on cough frequency (MD -0.49; 95% CI -1.15 to 0.17); cough severity (MD -0.50; 95% CI -1.28 to 0.29), bothersome cough (MD -0.29; 95% CI -1.14 to 0.56) and sleep quality of the children (MD -0.70; 95% CI -1.57 to 0.17) or their parents (MD -0.34; 95% CI -1.24 to 0.55).. We found insufficient evidence to advise for or against the use of honey for acute cough in children.

Topics: Antitussive Agents; Apitherapy; Child; Cough; Dextromethorphan; Humans; Sleep Wake Disorders

The aim of this study was to evaluate the efficacy of a single night-time dose of a syrup containing paracetamol, dextromethorphan hydrobromide, doxylamine succinate and ephedrine sulfate in subjects with multiple cold symptoms.. A syrup containing 15 mg dextromethorphan hydrobromide, 7.5 mg doxylamine succinate, 600 mg paracetamol and 8 mg ephedrine sulfate (Wick MediNait produced by WICK Pharma, Germany, a subsidiary of Procter & Gamble GmbH; test syrup) or placebo (placebo syrup) for oral administration.. This was a randomized, double-blind, placebo-controlled, multi-center, parallel design study. At enrollment, eligible subjects had to have at least moderate nasal congestion and a runny nose, at least mild cough and at least mild pain with one or more of the following: sore throat, sore chest, headache or body pain/aches. Subjects were randomized into either Group T (test syrup) or Group P (placebo syrup). On the evening of enrollment, subjects rated baseline symptoms, ingested the assigned study product and completed symptom-relief assessments at 3 hours post-dosing. Within one hour of awakening the following morning, subjects completed night-time symptom relief and sleep satisfaction assessments. All symptoms were recorded using an Interactive Voice Response system. Treatment comparisons were made after adjusting for the severity of baseline symptom using analysis of covariance.. Of 485 subjects who took the study product, 432 (224 in Group T; 208 in Group P) were evaluable for analysis. For the primary endpoint (composite of nasal congestion/runny nose/cough/pain relief scores 3 hours post-dosing), subjects in Group T had clinically and statistically significantly greater relief than Group P (p = 0.0002). Each individual symptom score also showed statistically significant improvement at this time point (p < or = 0.017). The next morning, Group T continued to show clinically and statistically significant benefits over Group P on the composite score and each of the individual symptoms (p < or = 0.003). Evidence of benefit with the test syrup was also seen in the higher score for overall night-time relief (p < 0.0001) and greater satisfaction on sleep (p = 0.002) compared to placebo syrup. Improvement in individual symptoms after 3 hours was obtained in 16-42% more subjects in Group T than in Group P, whereas the percentage of subjects in Group T having Good or Very Good relief the morning after dosing increased by 25-68% compared to subjects in Group P. 14 subjects (5 in Group T; 9 in Group P) reported AEs but none of these occurred with an incidence greater than 1%. There were no serious AEs.. The results confirm the multisymptom benefit of a single dose of the test syrup containing paracetamol, dextromethorphan hydrobromide, doxylamine succinate and ephedrine sulfate and support its role as an effective and convenient therapy for symptoms of nasal congestion, runny nose, cough and pain/body aches associated with the common cold and for increasing sleep quality disturbed by the common cold.

Topics: Acetaminophen; Adolescent; Adult; Analgesics, Non-Narcotic; Antitussive Agents; Bronchodilator Agents; Common Cold; Dextromethorphan; Double-Blind Method; Doxylamine; Drug Combinations; Ephedrine; Female; Histamine H1 Antagonists; Humans; Male; Middle Aged; Prospective Studies; Sleep Wake Disorders

To compare the effects of a single nocturnal dose of buckwheat honey or honey-flavored dextromethorphan (DM) with no treatment on nocturnal cough and sleep difficulty associated with childhood upper respiratory tract infections.. A survey was administered to parents on 2 consecutive days, first on the day of presentation when no medication had been given the prior evening and then the next day when honey, honey-flavored DM, or no treatment had been given prior to bedtime according to a partially double-blinded randomization scheme.. A single, outpatient, general pediatric practice.. One hundred five children aged 2 to 18 years with upper respiratory tract infections, nocturnal symptoms, and illness duration of 7 days or less.. A single dose of buckwheat honey, honey-flavored DM, or no treatment administered 30 minutes prior to bedtime.. Cough frequency, cough severity, bothersome nature of cough, and child and parent sleep quality.. Significant differences in symptom improvement were detected between treatment groups, with honey consistently scoring the best and no treatment scoring the worst. In paired comparisons, honey was significantly superior to no treatment for cough frequency and the combined score, but DM was not better than no treatment for any outcome. Comparison of honey with DM revealed no significant differences.. In a comparison of honey, DM, and no treatment, parents rated honey most favorably for symptomatic relief of their child's nocturnal cough and sleep difficulty due to upper respiratory tract infection. Honey may be a preferable treatment for the cough and sleep difficulty associated with childhood upper respiratory tract infection.. clinicaltrials.gov Identifier: NCT00127686.

Topics: Adolescent; Antitussive Agents; Child; Child Welfare; Child, Preschool; Cough; Dextromethorphan; Female; Health Surveys; Honey; Humans; Male; Parents; Respiratory Tract Infections; Sleep; Sleep Wake Disorders

Twenty-four inpatients affected by chronic cough completed a single-dose double-blind cross-over study of placebo, glaucine 30 mg and dextromethorphan 30 mg. The study was carried out using a balanced incomplete block design, each patient receiving two of the three experimental treatments. Objective evaluation of cough was ensured by means of a writing cough recorder. Coughs after dextromethorphan and glaucine were fewer than coughs after placebo: however only glaucine was significantly different from placebo in reducing coughs. Treatments were well tolerated: clinical results included a reduction in pulse rate after both dextromethorphan and glaucine , and a large number of patients reporting side effects after dextromethorphan administration.

Topics: Adult; Aged; Antitussive Agents; Aporphines; Clinical Trials as Topic; Cough; Dextromethorphan; Double-Blind Method; Female; Headache; Humans; Levorphanol; Male; Middle Aged; Pulse; Random Allocation; Sleep Wake Disorders; Vision Disorders

Topics: Antitussive Agents; Child; Dextromethorphan; Diphenhydramine; Humans; Nonprescription Drugs; Sleep Wake Disorders