Introduction: Study on animals showed that increase of serotonin level in brain of cats has an inhibiting influence on the central generating mechanism of cough reflex. Among the serotonin receptors involved in cough control the 5-HT1 and 5- HT1A take the most important part. In other studies published recently efficiency of using Paroxetine as cough inhibitor was suggested (study on 5 patients).Paroxetine and Fluvoxamine are antidepressants and belong to SSRI (Serotonin Selective Reuptake Inhibitors) group, used in depression treatment.
Main goal of the study: 1.is anticough effect specific for Paroxetine only or is common for group of SSRI? 2.finding alternative treatment for expensive Paroxetin used in Poland.
Material and Methods: 6 patients in palliative care team at the time of study. Main medical problem was persistent, distressing dry cough impairing normal life. The cause of cough was cancer first placed in bronchus (4 cases) and multiple metastases to lungs from other organs. All of them were previously treated with anticough medicines (codeine and morphine). In the study patients took Fluvoxamine (SSRI group), 50 mg once a day for 1 - 3 months.
Results: Intensity and frequency of cough was clearly reduced but not permanently eliminated. All of the patients asserted that vehemence of cough was weakened. After administration of 50 mg of Fluvoxamine in patients with cough, sleepiness was observed and lasted for several hours (24 in some cases).
Conclusions: The main goal was evaluation of anti cough effect of Fluvoxamine, which appeared to be equally effective as Paroxetine. But the cough was not totally eliminated. Sleepiness was also observed in patients treated with Paroxetine. There is a suspicion that patients suffering from persistent exhausting cough fall asleep after they have received cough relieving medicine. This conclusion is not certain and the side effect should be attentively observed.