The American College of Chest Physicians (ACCP) is now advising people not to take over-the-counter (OTC) cough medicines for cold-related coughs. Recent research reports there is no scientific evidence that suppressants like dextromethorphan or expectorants like guaifenesin effectively relieve cold-related coughs. According to the ACCP, nearly 30 million visits to doctors' offices each year in the U.S. are for coughs.
This advice is part of new comprehensive guidelines on diagnosing and treating coughs that were published in the journal Chest. The guidelines committee reviewed hundreds of studies dating back decades and found no scientific evidence that OTC drugs relieve coughs that are the result of colds. Findings also revealed that OTC cough medicines have a strong placebo effect and cold-related coughs eventually resolve on their own.
In another study, researchers at Pennsylvania State College of Medicine administered either dextromethorphan, diphenhydramine, or a placebo to 100 children with symptomatic upper respiratory infections. They found that there was no significant difference in the treatments. "Diphenhydramine and dextromethorphan are not superior to placebo in providing nocturnal symptom relief for children with cough and sleep difficulty as a result of an upper respiratory infection," the study authors conclude. "Each clinician should consider these findings, the potential for adverse effects, and the individual and cumulative costs of the drugs before recommending them to families."
Other research conducted by the Cochrane Collaboration, a non-profit group that reviews scientific evidence for medical treatments, has found that there was no evidence either for or against the effectiveness of OTC cough medicines.
Wyeth, maker of Robitussin products, disagrees with the ACCP's conclusions. "Our stance is that the FDA has reviewed dextromethorphan and guaifenesin and found the two ingredients to be both safe and effective," says Fran Sullivan, Wyeth's spokesperson, in a USA Today article. "We don't believe that consumers would...re-purchase these products if they weren't efficacious."
REFERENCES:
1. Irwin RS et al. Diagnosis and Management of Cough Executive Summary: ACCP Evidence-Based Clinical Practice Guidelines. Chest. 2006;129:1S-23S.)
2. Paul IM et al. Effect of dextromethorphan, diphenhydramine, and placebo on nocturnal cough and sleep quality for coughing children and their parents. Pediatrics 2004 Jul;114(1):e85-90.
3. Rubin R. "Cough syrup left out in the cold." USA Today, January 9, 2006, online: http://www.usatoday.com/news/health/2006-01-09-cough_x.htm
Posted by Elaine Gavalas on June 12, 2006 10:42 AM
