Strange cough for more than a year

[Poppy94]

I have had a cough for more than a year now. It started as a strange tickle in my throat that would cause me to cough uncontrollably. I try to clear my throat to avoid the cough but most of the time this doesn't work. Sometimes I cough so hard and so long that I gasp for air, feel like I am going to vomit, get dizzy and/or get a headache. The cough can start at any time but it usually always comes on when I laugh or lay down. When I lay down it feels like my lungs are filling up and expanding. In December of 2006 I coughed so hard that I dislocated cartilage on my sternum. This is a dry cough usually with weezing. I have taken singulair and albuterol which are not helping at all. Any advise would be wonderful!

P~

[National Jewish Health]

You may want to show the following information to your doctor.  Together you and your physician may want to review the most common causes of cough (see Conclusions, below) and, if none of these is the cause, he/she may want to consider this report from the Cleveland Clinic.  Further details about a "Cough Clinic" at either the Cleveland Clinic or the University of Rochester, in Rochester, N.Y, could probably be obtained from Dr. Jeyakumar at:  ***@****

Good luck.
The Laryngoscope
Volume 116(12), December 2006, pp 2108-2112
Effectiveness of Amitriptyline Versus Cough Suppressants in the Treatment of Chronic Cough Resulting From Postviral Vagal Neuropathy
[Triological Society Papers]
Jeyakumar, Anita MD; Brickman, Todd M. MD; Haben, Michael MD, MSc

From the Department of Otolaryngology (a.j.), Cleveland Clinic Foundation, Cleveland, Ohio, U.S.A.; and the Department of Otolaryngology (c.m.h., t.m.b.), University of Rochester, Rochester, New York, New York, U.S.A.
Editor's Note: This Manuscript was accepted for publication August 24, 2006.
Presented in part at the COSM meeting of the Triological Society Chicago, Illinois, U.S.A., May 19–22, 2006.
Send correspondence to Anita Jeyakumar, MD, Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH 44195, U.S.A. E-mail: ***@****
Abstract  
Objective: The objective of this prospective, randomized, controlled study (N = 28) was to evaluate the effectiveness of amitriptyline versus cough suppressants in the treatment of chronic cough resulting from postviral vagal neuropathy.


Results: A majority of patients in the amitriptyline group achieved a complete response on the initial dose of 10 mg. None of the codeine/guaifenesin group achieved a complete response. The data were analyzed using a logistic regression model, and amitriptyline was found to be a highly significant predictor of a greater than 50% response when compared with codeine/guaifenesin (P = .0007). The same data were analyzed using a proportional odds model and similar results were noted.

Conclusions: Chronic cough can have a profound impact on the psychosocial function of patients. The most common causes of a persisting cough in the absence of infection or chronic smoking are laryngopharyngeal reflux, asthma, particularly the cough variant, allergy, rhinosinusitis, bronchitis, and medications, in particular angiotensin-converting enzyme inhibitors. Currently, there are few effective treatments for cough with an acceptable therapeutic ratio and more selective drugs with a more favorable side effect profile are needed. This is this first prospective, randomized, controlled study comparing the effectiveness of amitriptyline versus codeine/guaifenesin for select cases of chronic cough resulting from suspected postviral vagal neuropathy.