Evidence supporting the use of: Theobromine
For the health condition: Cough (spastic)

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Synopsis

Source of validity: Scientific
Rating (out of 5): 3

Theobromine, a methylxanthine alkaloid found in cocoa and chocolate, has been investigated for its antitussive (cough-suppressant) effects. Scientific evidence supporting its use for spastic (persistent or severe) cough is moderate and primarily based on preclinical and small human studies. The main mechanism is thought to involve inhibition of the vagus nerve’s sensory nerve activity, which is responsible for the cough reflex. A notable study published in FASEB Journal (2004) by Usmani et al. demonstrated that theobromine was more effective than codeine at suppressing capsaicin-induced cough in healthy volunteers, without the sedative side effects or risk of addiction associated with opioid antitussives. The study suggested that theobromine acts by inhibiting phosphodiesterase and antagonizing adenosine receptors, both of which are involved in cough reflex modulation.

Further research, including animal studies, has shown consistent antitussive effects, but clinical data in patients with chronic or spastic cough are limited. Theobromine has not been widely adopted into clinical practice, and major guidelines do not currently recommend it as a first-line therapy. Nevertheless, the evidence base is growing, and the compound is being considered as a potential alternative to opioid-based cough suppressants. Overall, while there is promising scientific evidence, especially from controlled human studies, larger clinical trials are needed to fully establish its efficacy and safety in the treatment of spastic cough.

More about Theobromine
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