... amitriptyline, gabapentin, topomax and currently protriptyline. The amintriptyline and protriptyline both have calmed the cough some what, but I'm still coughing. Any other suggestions
After reviewing some literature about neurogenic cough, I found the following:
"Treatment of neurogenic chronic cough is somewhat different than other neuropathic conditions. For isolated cough (no-LPR), I usually start treatment with tramadol 25 mg q.i.d. p.r.n. or amitriptyline 10 mg q.h.s. If LPR is also present or there are other symptoms, then I tend to start with gabapentin 100 mg q.i.d. and then escalate the dose as needed (usually to 300-500 mg q.i.d.) depending on the side-effects and results. Those medications may be used alone or in combination, and the most common combination is gabapentin with a small dose of amitriptyline at bedtime. In my practice, pregabalin and baclofen are second-line choices for special situations."
Since you have tried the amitriptyline and gabapentin, you might want to try the tramadol with the protriptyline, or investigate the pregabalin (Lyrica) in place of the gabapentin and the baclofen which is a muscle relaxant.
Just some suggestions,
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