... 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.
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