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Opiate therapy in chronic cough.

Alyn H Morice1, Madhav S Menon, Siobhan A Mulrennan

  • 1Department of Academic Medicine, University of Hull, Castle Hill Hospital, Cottingham, East Yorkshire, UK. a.h.morice@hull.ac.uk

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Morphine sulfate effectively reduces chronic cough frequency and severity in patients resistant to other treatments. Doses of 5-10 mg twice daily showed significant improvements in cough symptoms.

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Area of Science:

  • Pulmonology
  • Pharmacology

Background:

  • Chronic cough is a common, debilitating condition.
  • Current antitussives lack evidence for chronic, treatment-resistant cough.

Purpose of the Study:

  • To evaluate the efficacy of morphine sulfate in reducing chronic cough.
  • To test a 5 mg twice daily dose of morphine sulfate.

Main Methods:

  • Randomized, double-blind, placebo-controlled study.
  • Slow-release morphine sulfate (5 mg BID) vs. placebo for 4 weeks.
  • Assessed cough using Leicester Cough Questionnaire, daily diary, and citric acid challenge.

Main Results:

  • Significant improvement in Leicester Cough Questionnaire scores (3.2 points, p < 0.01).
  • 40% reduction in daily cough scores with morphine sulfate (p < 0.01).
  • No significant change in cough reflex sensitivity via citric acid challenge.

Conclusions:

  • Morphine sulfate is effective for intractable chronic cough.
  • Doses of 5-10 mg twice daily provide significant antitussive effects.