Chronic Cough: Evaluation and Management

Charlie Michaudet, MD; John Malaty, MD


Am Fam Physician. 2017;96(9):575-580. 

In This Article

Options for Refractory Cough

Patients with unexplained chronic cough after evaluation and treatment of common causes should be referred to a pulmonologist or otolaryngologist.[4,5] Neuromodulators have shown some benefit in randomized trials based on the hypothesis that refractory chronic cough may be due to hypersensitivity of the cough reflex caused by peripheral (afferent limb of the cough reflex) and central mechanisms (central sensitization).[36–38] Therapies included gabapentin (Neurontin, 1,800 mg per day), which improved symptoms within four weeks; pregabalin (Lyrica, 300 mg per day) in conjunction with speech therapy, which showed greater improvement vs. placebo with speech therapy; and speech and language therapy alone.[39–41]