Publication: The Effectiveness of Nortriptyline and Tolerability of Side Effects in Neurogenic Cough Patients
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Issued Date
2020
Resource Type
File Type
application/pdf
ISSN
34894
Other identifier(s)
2-s2.0-85096324541
Rights Holder(s)
Scopus
Bibliographic Citation
Annals of Otology, Rhinology and Laryngology. (2020)
Suggested Citation
Song S.A., Choksawad K., Franco R.A., Jr. The Effectiveness of Nortriptyline and Tolerability of Side Effects in Neurogenic Cough Patients. Annals of Otology, Rhinology and Laryngology. (2020). doi:10.1177/0003489420970234 Retrieved from: https://hdl.handle.net/20.500.14740/4872
Author(s)
Abstract
Objective: To determine the effectiveness of nortriptyline and tolerability of side effects in the treatment of neurogenic cough. Secondary goal is to evaluate the association between laryngeal asymmetry and clinical response to nortriptyline. Study Design: Retrospective case series. Materials and Methods: Consecutive patients diagnosed with neurogenic cough at a quaternary care specialty hospital from 2001 to 2020 were identified. Subjects <18 years old, not treated with nortriptyline, did not have a nasolaryngoscopic examination and were lost to follow-up were excluded. Charts were reviewed for demographic information, clinical history, nasolaryngoscopic findings, medication dosage, side effects, and follow-up time. Results: Forty-two patients met inclusion and exclusion criteria, 7 males and 35 females with an average age of 56.5 (±13.1) years. There were 26/36 (72.2%) responders and 10/36 (27.8%) non-responders; 6 patients stopped nortriptyline due to side effects and were not included in the response comparison. Laryngeal asymmetry was present in 36/42 (85.7%) patients. No factors related to laryngeal asymmetry were significantly different between responders and non-responders. Medication tolerance was observed in 3/42 (7.1%) patients. Side effects were reported in 16/42 (38.1%) patients. The most common side effects were sedation 9/42 (21.4%) and xerostomia 3/42 (7.1%). Conclusion: Nortriptyline is effective for treating neurogenic cough with 72% of patients reporting improvement in cough. Evidence of laryngeal asymmetry was not associated with better treatment response. Although 38% experienced side effects, the majority of patients continued nortriptyline despite side effects. Level of Evidence: 4 © The Author(s) 2020.