pregabalin and Cough

There are few effective pharmacological therapies available to treat refractory chronic cough. Functional MRI studies of the brain have recently shown that patients with chronic cough have dysfunctional inhibitory control of cough. Self-management therapies delivered by physiotherapists or speech therapists are effective at suppressing cough. They enable patients to consciously suppress the urge to cough. The intervention consists of education, laryngeal hygiene, cough suppression and distraction measures and behaviour modification. The efficacy of Physiotherapy and Speech And Language Intervention (PSALTI) has been confirmed in two randomised control trials. In one trial, there was a 41% reduction in cough frequency with PSALTI, assessed objectively with the Leicester Cough Monitor, and a clinically significant improvement in quality of life. Importantly, the improvement in cough was sustained when therapy was discontinued. The addition of the Speech Pathology Treatment to neuromodulator drug therapy, Pregabalin has also been evaluated in a clinical trial. There was a clinically significant improvement in quality of life, and this was sustained when therapy was discontinued. The mechanism of action of PSALTI is not known and this should be investigated in future. Further studies are needed to identify the components of PSALTI that deliver the most benefit, and determine whether PSALTI is effective in cough associated with other chronic lung disorders.

Topics: Brain; Chronic Disease; Combined Modality Therapy; Cough; Humans; Language Therapy; Magnetic Resonance Imaging; Physical Therapy Modalities; Pregabalin; Quality of Life; Randomized Controlled Trials as Topic; Speech Therapy

Topics: Amines; Amitriptyline; Chronic Disease; Cough; Cyclohexanecarboxylic Acids; Gabapentin; gamma-Aminobutyric Acid; Humans; Neurotransmitter Agents; Practice Guidelines as Topic; Pregabalin

The goal of this systematic review was to examine the evidence for the use of the neuromodulating agents, amitriptyline, gabapentin, pregabalin, and baclofen, in the management of chronic, idiopathic cough patients.. Online databases, including PubMed, Embase, Cochrane Review, and Web of Science, and publications cited in bibliographies were used.. Literature was searched by the 2 authors with a priori criteria for study selection.. Eight relevant articles were identified, including 2 randomized controlled trials, 2 prospective cohort or case-series designs with consecutive patients, 1 retrospective case series of consecutive patients, 1 retrospective case series whose consecutive status was not known, and 2 case reports of 6 and 2 patients, respectively. Improvements in cough-specific quality of life were noted in the randomized controlled trials. Cough severity was reduced in studies that measured this outcome measure. In the remaining studies, cough symptoms were less after neuromodulator treatment.. Benefit from neuromodulator treatment with amitriptyline, gabapentin, pregabalin, and baclofen in chronic, idiopathic cough patients was demonstrated. Further investigations using objective and subjective outcome measures are needed as well as studies exploring optimal dose, length of treatment, and relapse rates posttreatment.

Topics: Amines; Amitriptyline; Baclofen; Chronic Disease; Cough; Cyclohexanecarboxylic Acids; Gabapentin; gamma-Aminobutyric Acid; Humans; Neurotransmitter Agents; Pregabalin; Quality of Life

Recent literature points to postviral sensory neuropathy as a possible cause for refractory chronic cough. Vagal neuropathy may affect the sensory branches, inducing chronic cough or laryngospasm. Although the clinical presentation is fairly well described, there is little in the way of diagnostic criteria to establish this diagnosis. This article highlights the clinical picture of this disease and the efficacy, side-effect profiles of the currently used pharmacological interventions.

Topics: Adrenergic Uptake Inhibitors; Amines; Amitriptyline; Anticonvulsants; Chronic Disease; Cough; Cyclohexanecarboxylic Acids; Gabapentin; gamma-Aminobutyric Acid; Humans; Pregabalin; Vagus Nerve Diseases; Virus Diseases

Conscious sedation is usually required during flexible bronchoscopy. Sedation should be achieved without respiratory depression or loss of consciousness. The present study was designed to evaluate the effect of pregabalin premedication on reducing the amount of sedatives and to show its advantages for patients undergoing flexible bronchoscopy with dexmedetomidine.. Seventy patients undergoing elective flexible bronchoscopy were randomly divided into two groups of 35 patients each. All patients received premedication one hour before the procedure. PG group received 150 mg pregabalin and C group received placebo. All patients were sedated with dexmedetomidine infusion to achieve optimum sedation. During the procedure peripheral oxygen saturation, respiratory rate, hemodynamics, Ramsay sedation Score, cough score, and total amount of dexmedetomidine used were recoded. After the procedure patients' and pulmonologists' satisfaction were compared.. The total amount of dexmedetomidine used in PG was less compared to C group (P=0.01). Sedation score was higher in PG group at the time of theatre admission (P<0.001). Cough score was higher, but insignificant in group C (P=0.08). Patients' and pulmonologists' satisfaction scores were higher in group PG (P=0.007 and 0.001 respectively). The heart rate and mean arterial pressure were lower in the C group (P=0.02 and 0.03 respectively). Postoperative care unit stay was less in group PG with less analgesic requirements.. Conscious sedation facilitates flexible bronchoscopy. Premedication with pregabalin can reduce the amount of sedatives. Dexmedetomidine with pregabalin premedication has many advantages over dexmedetomidine alone.

Topics: Adult; Aged; Anesthesia Recovery Period; Bronchoscopy; Conscious Sedation; Cough; Dexmedetomidine; Double-Blind Method; Female; Hemodynamics; Humans; Hypnotics and Sedatives; Male; Middle Aged; Oxygen; Patient Satisfaction; Preanesthetic Medication; Pregabalin; Respiratory Rate

Chronic refractory cough (CRC) is a difficult problem to treat. Speech pathology treatment (SPT) improves symptoms but resolution is incomplete. Centrally acting neuromodulators also improve cough symptoms, but not cough reflex sensitivity, and the effect is short-lived. We hypothesized that combined SPT and centrally acting neuromodulators would have a superior outcome than SPT alone. Our goal was to determine whether combined pregabalin and SPT is more effective than SPT alone.. Randomized placebo controlled trial. Forty patients with CRC were randomly assigned to receive either combined SPT and pregabalin 300 mg daily or combined SPT and placebo. Outcome measures were collected at baseline, end of treatment, and 4 weeks after the end of treatment. Primary outcome measures were cough frequency using the Leicester Cough Monitor, cough severity using a visual analog scale (coughVAS), and cough-related quality of life (QOL) using the Leicester Cough Questionnaire (LCQ).. Cough severity, cough frequency, and cough QOL improved in both groups. The degree of improvement in LCQ and coughVAS was greater with combined SPT and pregabalin than SPT alone; the mean difference in LCQ was 3.5, 95%CI of difference 1.1 to 5.8; the mean difference in coughVAS was 25.1, 95% CI of difference 10.6 to 39.6. There was no significant difference in improvement in cough frequency between groups. There was no deterioration in symptoms once pregabalin was withdrawn. Median capsaicin cough sensitivity improved from 15.7 to 47.5 μM with combined SPT and pregabalin and from 3.92 to 15.7 μM with SPT alone.. Combined SPT and pregabalin reduces symptoms and improves QOL compared with SPT alone in patients with CRC.

Topics: Aged; Analgesics; Chronic Disease; Combined Modality Therapy; Cough; Double-Blind Method; Female; Humans; Male; Middle Aged; Pregabalin; Quality of Life; Severity of Illness Index; Speech-Language Pathology; Surveys and Questionnaires; Treatment Outcome

Patients with chronic cough (>8 weeks) often remain symptomatic after appropriate investigations and therapeutic trials. Prior research has shown a benefit in certain individuals from pregabalin, but clinical improvement is quite unpredictable and variable.. The main objective of this study was to identify the demographic and clinical characteristics associated with a higher likelihood of cough improvement with a trial of pregabalin therapy.. 50 consecutive patients with chronic cough were enrolled in this prospective cohort study. Subjects were prescribed pregabalin 75 mg oral qhs for 4 weeks followed by 75 mg oral bid. Leicester Cough Questionnaire (LCQ) was completed at treatment initiation and after 3 months of therapy. A comparison was performed between treatment responders (LCQ total score improvement ≥1.3) and non-responders.. 56% of patients reported a LCQ total score improvement ≥1.3 (minimal clinically important difference). Responders to pregabalin therapy were more likely to have refractory (with underlying pulmonary disease) versus unexplained chronic cough (p = 0.01). Patients with significant improvement were also on average more symptomatic at baseline (mean LCQ total score 10.2 versus 13.0, p < 0.01). No significant relationship was identified with age, gender, body mass index, history of anxiety and/or depression, cigarette smoking history, or cough duration (p > 0.05). The unexplained chronic cough group had a strong female predominance (85.7% versus 40.9% for refractory cough, p < 0.01).. This is the first study that has investigated clinical predictors of treatment response to pregabalin in chronic cough patients. Further research is needed to develop therapies for subjects who do not improve with currently available neuromodulating medications.

Topics: Chronic Disease; Cough; Female; Humans; Male; Pregabalin; Prospective Studies; Quality of Life; Surveys and Questionnaires

Topics: Analgesics; Cough; COVID-19; Humans; Intensive Care Units; Pregabalin; SARS-CoV-2

Topics: Adult; Air Pollution, Indoor; Antifungal Agents; Antitussive Agents; Chronic Disease; Coriolaceae; Cough; Drug Interactions; Female; Humans; Hypersensitivity; Itraconazole; Male; Medically Unexplained Symptoms; Middle Aged; Mycoses; Pregabalin; Sensation; Skin Tests; Sputum

Chronic refractory cough (CRC) is a common clinical problem which is more likely associated with some physical problems. Although many patients have received satisfactory treatment, there were still many patients suffered from long-term cough symptoms after standardized treatment.. A patient suffered from postherpetic neuralgia (PHN) and also he complained CRC for more than 20 years.. The patient was diagnosed with PHN and CRC.. Pregabalin was originally administered to treat PHN.. pregabalin not only alleviated her pain of PHN but also relieved chronic cough.. This report demonstrated the surprising effect of pregabalin on the treatment of CRC.

Topics: Analgesics; Chronic Disease; Cough; Female; Humans; Middle Aged; Neuralgia, Postherpetic; Pregabalin; Treatment Outcome

Talking is a significant trigger for cough in patients with chronic cough; however, the stimulus required to trigger cough has not been quantified. The aim of this study was to examine the effect of a vocal loading task on phonation and cough behavior in patients with chronic cough and identify change following therapy.. This is a prospective observational study.. This study involved 33 patients with chronic cough. Participants were assessed with the lingWAVES Vocal Loading Test protocol before and after intervention for chronic cough.. At baseline, almost 40% of patients had impaired vocal function and were unable to complete the vocal loading test. This improved following therapy, with 94% of patients being able to complete the test at follow-up. There was difficulty maintaining phonation, with 60% of the task unvoiced at baseline. This improved following therapy. The vocal loading test triggered coughing in 58% of patients; however, this improved following intervention. Acoustic measures during the vocal loading test did not change following therapy.. Phonation is an important trigger for cough. Patients with chronic cough demonstrated impaired performance on tests of vocal loading. Most parameters improved following therapy.

Topics: Acoustics; Aged; Chronic Disease; Cough; Female; Humans; Larynx; Male; Middle Aged; Phonation; Pregabalin; Prospective Studies; Randomized Controlled Trials as Topic; Sound Spectrography; Speech Acoustics; Speech Production Measurement; Time Factors; Treatment Outcome; Voice Disorders; Voice Quality

Topics: Analgesics; Cough; Female; Humans; Male; Pregabalin; Speech-Language Pathology