Centrally acting drugs such as codeine and morphine can influence the central reflex control of coughing but are associated with well-known adverse effects. Cough hypersensitivity may occur at both the peripheral and central levels, or both; in accordance with the use of gabapentin for neuropathic pain, such medications in chronic cough also exerted positive effects on cough symptoms. In this issue of CHEST (see page 639), Vertigan et al found that a combination of pregabalin and speech therapy improved cough severity, cough frequency, and cough quality of life in patients with UCC. The study included patients with earlier treatment failure and no obvious medical explanation for coughing. By using a cough monitor and measuring cough severity with validated instruments such as a visual analogue scale and the Leicester Cough Questionnaire, the authors produced reliable results supporting the treatment of chronic cough with a centrally acting neuromodulatory drug, together with speech therapy probably targeting peripheral mechanisms. The findings remind us to use nonpharmacologic methods as options for managing difficult-to-treat conditions. Although it is necessary to be aware of potential adverse effects when using centrally acting medications, the article by Vertigan et al gives important signals for physicians to try new methods in cough treatment and the need for new guidelines in chronic cough. Such guidelines, suggesting a new way to assess and treat UCC, are now being developed based on a systematic review of randomized controlled clinical trials using CHEST organization methodology. An expert panel valued the efficacy of treatment compared with customary care on cough severity, cough frequency, and cough-related quality of life. Both speech pathology-based cough suppression and neuromodulatory drugs were suggested as treatment options. The guidelines also highlight our current limited knowledge and suggest UCC as an area for future research for determining uniformed terminology, methods of investigations, and treatment policy.