Gabapentin as a Potential Treatment for Cough Syncope

Wu, Clara Hoi Ka; Gunasekara, Keith; Hull, James H.; Bikov, András; Morris, Adrian; Usmani, Omar

doi:10.4187/respcare.03255

Cited by 10 publications

(6 citation statements)

References 30 publications

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“…Wu et al. [10] reported that a very low dose (200 mg) of Gabapentin was sufficient to treat and completely control cough syncope in their patient and avoiding the side effects of the high doses. They suggested starting with a dose of 100 mg daily and increasing by 100 mg daily every 2 weeks until a subjective improvement in cough is achieved.…”

Section: Discussionmentioning

confidence: 99%

Cough syncope induced by post nasal drip successfully managed by Gabapentin

Algahtani

Shirah

2017

Respiratory Medicine Case Reports

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Syncope is a common complaint in both neurology clinic and emergency department. It is defined as transient loss of consciousness with loss of postural tone, which is usually self-limited and followed by a spontaneous recovery. Our report describes a case of cough syncope resulting from chronic intractable cough caused by post nasal drip. Although his experience was debilitating, we were able to control his symptoms significantly using a small dose of Gabapentin. This dose is much lower when compared with the already established licensed indicated higher doses used for the treatment of neuropathic pain and epilepsy. Cough syncope is a demanding condition that results in comprehensive costly investigations. In addition, cough syncope could be misinterpreted as epilepsy by the treating team. Pulmonologists should be aware of the use of Gabapentin as the management of cough refractory to standard antitussive therapy. Further studies are needed to assess the effectiveness of low doses of Gabapentin in the management of chronic cough.

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Section: Discussionmentioning

confidence: 99%

Cough syncope induced by post nasal drip successfully managed by Gabapentin

Algahtani

Shirah

2017

Respiratory Medicine Case Reports

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“…It more commonly occurs in middle-aged, obese smoker males with obstructive lung disease [1][2][3]. Until yet, more than 470 cases of cough syncope have been reported in the medical literature [1,[4][5][6]. This syndrome could be accompanied with significant increase of morbidity and mortality as with any syncope.…”

Section: Discussionmentioning

confidence: 99%

“…A variety of disorders of the respiratory tract, of the central nervous system, cardiovascular system, gastrointestinal system, and other disorders have been associated with the occurrence of cough syncope [1]. To the best of our knowledge, until yet more than 470 adult cases of cough syncope have been reported in the medical literature [1,[4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Recurrent Cough Syncope Due to Pertussis in Adults: Report of Three Cases and Review of the Literature

et al. 2016

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Cough syncope, also called "tussive syncope", is a well-recognized syndrome for about 70 years, in which loss of consciousness usually occurs immediately after a violent cough or prolonged bouts of violent coughing, lasting for seconds with rapid restoration of full consciousness. Its precise pathophysiologic mechanism is not fully understood and remains a matter of debate. Although pertussis is a frequent cause of prolonged cough in adults, still its burden in this age group is under-appreciated and under-diagnosed worldwide. This is well reflected by the fact that despite cough syncope is definitely not rare, until yet only six cases of cough syncope related to pertussis have been reported in the medical literature, one of them by us. We describe additional three adults with recurrent cough syncope due to pertussis who were diagnosed during a period of 3 months which completely resolved by treatment with azithromycin. Diagnosing four cases of cough syncope in adults due to pertussis during a short period in one Department of Internal Medicine, while only five cases were reported from the rest of the world, reflects the great lack of awareness on adult pertussis worldwide. Our four cases indicate that physicians should be much more aware of pertussis as a cause of cough and cough syncope in adults in order to terminate the attacks of cough and cough syncope and its serious complications by adequate antibiotic treatment, as happened with our four patients.

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“…Although current FDA-approved indications only include adjunct therapy for partial seizures and postherpetic neuralgia, gabapentin has numerous off-label uses, including the treatment of CRC. 75 Thus far, 12 current studies 54,56,[60][61][62][63][64][65][66][67][68][69] show favorable therapeutic effects of gabapentin; however, a standardized dose, optimal treatment duration, and longterm safety data have not been established. The American • PO amitriptyline 10 mg/day given QHS or 10 mL PO codeine/ guaifenesin 10 to 100 mg/5 mL every 6 hours standing dose while awake.…”

Section: Gabapentinmentioning

confidence: 99%

Treatment of Chronic Refractory Cough in Adults: Focus on Neuromodulators and Other Therapeutic Modalities

O’Hare

Rahman

Williams

2020

Journal of Pharmacy Technology

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Objective: To evaluate the literature and educate health care professionals about the different management options for chronic refractory cough (CRC). Data Sources: Searches were performed through MEDLINE (1966 to July 2020) using OVID and EBSCOhost and EMBASE (1947 to July 2020) using OVID. Search terms included chronic cough, neurogenic cough, neuromodulators, chronic cough management, and chronic cough treatment. References of all relevant articles were further used to obtain additional articles. Study Selection and Data Extraction: This review includes articles in the English language and human trial literature. Twenty-three trials explored the use of oral neuromodulators in the management of CRC. Data Synthesis: CRC is a poorly understood disease that may have a complex neuropathic etiology. Oral neuromodulators, such as amitriptyline, baclofen, gabapentin, and pregabalin, continue to be the most commonly used agents for the management of CRC. Alternative pharmacological therapies such as botulinum toxin, anesthetic agents (benzonatate, lidocaine), and narcotic agents have efficacy data, and further research into effective doses and routes of administration is warranted. Alternative nonpharmacologic therapies more commonly used included speech pathology treatment. Conclusion: Several medication and alternative treatment interventions may be effective in managing CRC. Current studies used wide dosing and titration strategies, making it challenging to standardize therapy. No consistent method of assessing cough reflex was used between studies, as well as a lack of consistent randomization and small sample sizes. Additional research is needed to standardize treatment durations, optimum doses, and place in therapy of the available interventions in the management of CRC.

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Gabapentin as a Potential Treatment for Cough Syncope

Cited by 10 publications

References 30 publications

Cough syncope induced by post nasal drip successfully managed by Gabapentin

Cough syncope induced by post nasal drip successfully managed by Gabapentin

Recurrent Cough Syncope Due to Pertussis in Adults: Report of Three Cases and Review of the Literature

Treatment of Chronic Refractory Cough in Adults: Focus on Neuromodulators and Other Therapeutic Modalities

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