- A glass of water will do as much to relieve your child's
cough as an expensive, over-the-counter cough syrup, a new study suggests.The
research, published in today's edition of the medical journal Pediatrics,
concludes that parents who treat a child's nighttime cough with the widely
available medications are wasting their money.
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- "Consumers spend billions of dollars each year on
over-the-counter medications for cough," said Ian Paul, an assistant
professor of pediatrics at Penn State Children's Hospital in Hershey, Pa.
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- "But our study showed that the two ingredients used
in most over-the-counter medications were no better than a placebo, non-medicated
syrup, in providing nighttime relief for children with cough and sleep
difficulty as a result of upper-respiratory infection," he said.
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- In Canada, cough syrup sales exceed $80-million a year,
according to the Non-Prescription Drug Manufacturers Association.
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- About 95 per cent of syrups, including the best-selling
brands Benylin DM and Robitussin, have dextromethorphan as their active
ingredient. It is an expectorant, meaning it is supposed to clear the respiratory
tract of phlegm and make breathing easier. Other cough syrups contain diphenhydramine,
an antihistamine, designed to reduce swelling in the respiratory tract.
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- To conduct the study, researchers recruited 100 children
with upper-respiratory-tract infections who had been coughing for an average
of more than three days.
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- The children were given one of three treatments 30 minutes
before bedtime: A cough syrup containing dextromethorphan, a cough syrup
containing diphenhydramine or a placebo syrup.
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- Children in all three groups showed a dramatic reduction
in cough frequency, but those taking the placebo -- essentially flavoured
water -- had the best results. On four other measures, the three treatments
had virtually identical outcomes.
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- Dr. Paul said this demonstrates that time and proper
hydration are the best treatment for most respiratory infections and that
the benefit that comes from cough syrups is likely psychological.
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- "The desire to ease symptoms is strong for both
parents and clinicians. This study, however, questions whether over-the-counter
medications have a place in the treatment of these illnesses for children."
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- The study confirms what many physicians already know.
In fact, the Merck Manual of Diagnosis and Therapy, a reference book used
by physicians and written by an editorial board of medical experts, says
there is little evidence that cough syrups provide any benefit.
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- George Murray, co-owner of the Tantramar Pharmacy in
Sackville, N.B., said the new research is nonetheless useful because it
will get consumers thinking a little before reaching for medication.
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- "In my opinion, anything that pushes people to dialogue
with their pharmacist and make more informed choices is beneficial."
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- Mr. Murray said he generally tells people with respiratory
infections that fluid and rest are the best treatments, but he recognizes
that some seek the reassurance of taking an over-the-counter medication.
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- "If there's a placebo effect that works, why not?"
he said.
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- While they may not provide much benefit, the cough syrups
have virtually no side effects if taken at the recommended doses.
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- However, dextromethorphan, or DXM as it is known on the
streets, has become a popular recreational drug. Taken in significant doses
-- and up to 1,500 milligrams is not uncommon -- it is a psychedelic, one
that has found favour with computer fantasy game players.
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- Dr. Paul said while this was not a focus of his research,
the abuse of cough syrup by teenagers is another reason to not have the
product around the house.
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- Most pediatricians recommend that if a cough syrup is
used, that parents buy the smallest bottle and toss it out when the respiratory-tract
infection has passed.
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- Adult formulations of cough syrup are similar, but contain
higher doses of the active ingredients.
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