Exploring Guanfacine as a Treatment for Chronic Refractory Cough: A Case Study and Implications for Practice

Chronic refractory cough is a persistent and often debilitating condition that can significantly impact a patient's quality of life. Despite numerous treatment attempts, many patients find little relief from their symptoms. A recent case study published in Respiratory Medicine Case Reports by Kirschen et al. (2017) highlights the potential of guanfacine, an alpha-2-adrenergic agonist, as an effective treatment for neurogenic cough—a diagnosis often considered when other treatments fail.

The Case Study

The case involved a 58-year-old woman who had suffered from an 8-year history of chronic cough that was unresponsive to multiple conventional treatments. After ruling out common causes such as GERD, asthma, and sinus issues, the medical team considered neurogenic cough as a potential diagnosis. This decision led to the initiation of guanfacine monotherapy.

The patient experienced a rapid and durable improvement in symptoms with guanfacine, suggesting that her cough was likely neurogenic in origin. The treatment not only reduced the frequency of her coughing bouts but also improved her overall quality of life.

Implications for Practitioners

This case study offers several key takeaways for practitioners:

• Consider Neurogenic Cough: When faced with chronic cough cases that do not respond to standard treatments, practitioners should consider neurogenic cough as a possible diagnosis.
• Explore Guanfacine: The success of guanfacine in this case suggests it may be worth exploring as a treatment option for patients with similar symptoms. However, practitioners should be mindful of potential side effects such as dizziness and hypotension.
• Pursue Further Research: The promising results from this case highlight the need for further research into the use of guanfacine for neurogenic cough. Larger studies could provide more definitive evidence on its efficacy and safety.

The Role of Online Therapy Services

For schools and educational institutions dealing with students who may suffer from chronic coughs or related conditions, online therapy services like those provided by TinyEYE can be invaluable. These services offer accessible support and therapeutic interventions that can complement medical treatments like guanfacine.

Successful use of guanfacine in a patient with chronic refractory cough: A case report