... 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,
Same symptoms, but to make a long story short, after about 15 years as conditions worsened and no success with family doc, ENTs, lung specialists, gastrointestinal specialists, allergists, etc., I self diagnosed using Google and was confirmed with neurogenic cough by 2 different ENTs. That led to gabapentin (massive doses) and then tried amitriptyline. Finally in desperation Dr suggested low doses of tramadol (up to 4 25mg per day). Virtually instant relief!!! After all these years, a miracle. Thank you, Dr L! She's the best!
Jeff61st-was your wife part of the chronic cough study at the Mayo Clinic? My doctor recommended I contact them. She thought it involved botox injections, but I was worried about vocal cord paralysis. I'm at my wits end too. I was considering contacting the Mayo Clinic, but it sounds like the botox may not help.
Did you have your nerve clipped? If so who did it? I am in wi and having my 4th Botox inj. They have been unsuccessful. Still trying but I want something permanent. Thank you
Amitriptyline helped me a lot but I did not want to stay on it long term. I have had a noticeable cough for about 15 years, but it got really bad about 5 years ago. Finally was diagnosed I think it was in 2014 with neurogenic cough after many, many tests. I have continued to explore different possibilities for treatment. I would like to know if anyone else has noticed an increase in their coughing after consuming things like coffee and/or chocolate? Thanks.
I am so glad I found this on the internet. I am a relative "newbie" to neurogenic cough. I have had a cough for 2-1/2 years. Was diagnosed about a year ago and was so relieved to finally have a name for it. I knew I wasn't going crazy! :) I started out on 10mg amitriptyline once at bedtime and he has now increased it to two 10mg at bedtime. It was a lot better, but now it doesn't seem to be as effective. I've noticed I've been coughing a lot more lately. It's more than frustrating. Thank you, everyone, for the information you've shared, above. I'm going to make another appointment with my ENT and see if some of those other prescriptions may be more helpful to me.
I was on a cruise and a fellow passenger heard my coughing. His wife had a chronic cough for 15 years, heard about Dr. Jamie Koufman, (I'm not kidding--that's her name), in NY who wrote the book, "The Chronic Cough Enigma". She read the book, went to the doctor and was finally cured of her cough.
I just bought the book. I'm going to try some of the suggestions. My cough has been with me for almost 40 years. I just started referring to it as my "plus one." ;-)
I am 41yo, male, and I have had a neurogenic cough and throat clearing for 3 years now, following a bad virus that damaged a nerve. I am finally making real progress, so I wanted to share this with folks who may be suffering. I am posting this because I know how distressing the cough can be. For years I have experienced people literally getting up and finding a seat far away from me on the train or in closed spaces.
I have been through the misdiagnoses (asthma, allergies, tuburculosis, etc.) I was finally diagnosed by the late Barry Shapiro, ENT (Westchester, NY). He prescribed low levels of Amitriptyline and Gabapentin, both of which helped me to control the situation over a year. I constantly tinkered with dosing. However, these drugs had side effects and didn't get rid of the problem. Amitriptyline worked but put me to sleep.
Recently I went to see Dr. Jonathan Aviv (an ENT in Manhattan). He did an endoscopy and recommended voice therapy with a specialized therapist at his office named Andie Schneider. She gave me some ridiculously simple voice exercises to do every day (e.g. breathing in through the nose and then making an extended 'shhhhh' sound as long as possible). Needless to say I was very, very skeptical.
The crazy thing is that these exercises are working. They are retraining my vocal cords to not spasm and slam shut. I have not taken any of the drugs for several months now, and my cough/ throat clearing is maybe 75% improved. Today the therapist gave me some more exercises. I am doing them as I type these (some are also calming, like meditation).
Hope this helps someone to get better. Best of luck.
I know this original question was specific to neurogenic cough but I would like to reply. I have had a chronic cough for over 10 years and it has progressively gotten worse. I have been to every kind of specialist. GERD was suggested to me by several of them but since I did not have the typical symptoms, and I did not want to take a PPI, like Nexium, due to long term side effects I did not act on the diagnosis. I have a very wet cough (lots of mucus in my throat), but I also have a dry cough that seems to be triggered, not by food, but by temperature changes and chemicals to name a few. Finding Dr. Jamie Koufman's book "Chronic Cough" was a huge eye opener for me. She gives you some simple tests to help you to determine if you have Silent or respiratory reflux, neurogenic or a voice disorder. I tested high on the scale for reflux and moderate for neurogenic. The first thing she recommends is a diet change.
I have always felt that diet was the most important element in most ALL chronic disease , and I thought I was a healthier than average eater, but within two days of being on her low acid diet plan my cough was better by 50%. If you eat a lot of fast food or processed food this diet would be very difficult but if you are a basic healthy eater there are plenty of foods you can still eat, and ultimately you can go back to some of the banned foods once you get your symptoms under control and figure out which foods are making you cough. Also, years ago I had allergy testing for foods and many of the foods I showed an immune reaction to are the very same foods that are high in acid. For people who have tried many drugs with no luck I suggest getting her book and following her program. I will be forever grateful. Good luck and good to see I am not alone.
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