Docs sneeze at cough meds
Most over-the-counter cough syrups and drops do nothing for cold sufferers -- except make them a little lighter in the wallet -- according to new guidelines released Monday by the nation's chest physicians.
Not only are the bulk of these popular remedies ineffective at treating coughs due to the common cold, they should be avoided in children under 15 years old because they can spark side effects, the guidelines warn.
"There is no clinical evidence that over-the-counter cough expectorants or suppressants actually relieve cough," said Dr. Richard Irwin, who chaired the guidelines committee for the Northbrook-based American College of Chest Physicians. "Yet we continue to spend more and more money on them."
Older drugs shown to work
The committee's international team of experts analyzed the best available studies related to cough treatments. They found scant evidence that many nonprescription products either contain enough medication to work or include proven combinations of the right drugs. Little evidence supported the use of medicinal chest rubs and zinc, too.
Hackers take heart: Not everything in the over-the-counter aisle was a bust. The guidelines refrain from listing brand names, but they do say that older antihistamines combined with a decongestant -- ingredients found in Benadryl and Actifed, for example -- have been shown to lessen acute cough stemming from the common cold.
These drugs aren't for everyone. First-generation antihistamines and decongestants can cause problems for people with glaucoma or poor prostate health, for example.
Cough remedies made with newer, non-sedating antihistamines won't make you drowsy, but they also won't make your cough better, Irwin said.
"There is considerable evidence that older-type antihistamines help to reduce cough," Irwin said, "so unless there are contraindications to using these medicines, why not take something that has been proven to work?"
Makers of nonprescription cough medicines disputed the guidelines, insisting their products provide relief.
Results from placebo effect?
"There's been a long history of selling these," said Fran Sullivan, spokesman for Wyeth Consumer Healthcare, maker of medicine-cabinet staples, such as Robitussin and Dimetapp. "Unless the products provided some benefit, consumers wouldn't use them."
The popularity of cough meds could be chalked up to the large "placebo effect" that goes along with cold medications, meaning people often report feeling better even after taking a fake remedy.
"And that's OK," said Dr. Kristin Coyle, a family physician in the northwestern Illinois community of Sterling. Whether the benefits stem from a placebo or real chemistry, Coyle said she's seen over-the-counter cough medicines help a lot of adults and children.
"It gives the patient an empowering feeling if they can try something," said Coyle, who's used Robitussin DM herself. "It appeases them while the cough may be responding on its own."
