Comparison of pregabalin with doxepin in the management of uremic pruritus: a randomized single blind clinical trial

Foroutan, Nazanin; Etminan, Abbas; Nikvarz, Naemeh; Abadi, Mohadese Shojai Shahrokh

doi:10.1111/hdi.12455

Cited by 53 publications

(34 citation statements)

References 26 publications

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“…They also noted that the most antipruritic effects of pregabalin appeared at the end of the first week of the study, and the effects continued through the remained course of the trial. The mean scores of the VAS at baseline were 7.5 ± 1.4 and 7.1 ± 1.3, and at the end of the study were reduced to 2.1± 2.6 and 4.2 ± 2.6 in the pregabalin and doxepin group, respectively (32).…”

Section: Antipruritic Effects Of Pregabalin On Uremic Pruritusmentioning

confidence: 88%

Role of Pregabalin in Management of Pruritus: A Literature Review

Foroutan

Nikvarz

2016

J Pharm Pharm Sci

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-Purpose. Pruritus can be one of the distressing symptoms of many dermatologic, systemic, neurologic or psychiatric disorders. In each case, the origin of itch is in the skin and/or the nervous system. Involvement of the nervous system causes neurogenic, psychogenic or neuropathic itch. Itch sensation is transferred to the central nervous system via unmyelinated C-type nerve fibers, and many mediators and receptors engage in the its induction and transmission. Also it has been demonstrated that there are similarities and interactions between neurotransmitters and pathways of pain and itch sensation. Hence, effective drugs in reducing the neuropathic pain such as pregabalin have been studied and used in the management of different itchy conditions. In this narrative review we considered the available published papers dealing with the antipruritic effects of pregabalin. Results of studies conducted in uremic patients show that pregabalin is an effective option in reducing uremic pruritus especially in those who have not responded to antihistamines and topical moisturizers. Data about the effects of pregabalin on other itchy conditions are very limited; however results of the available studies show beneficial effects of this drug in burn patients with more than 5% involvement of the total body surface area, in prurigo nodularis, and in chronic and idiopathic itch. One considerable issue is that the therapeutic effects of pregabalin on uremic pruritus and post burn itch may appear more rapidly than its effects in the other conditions (1-2 weeks vs > 4 weeks). The most reported adverse effects of pregabalin are sedation, dizziness and drowsiness. Whether pregablin can be unequivocally considered as an effective and reasonable choice in the management of pruritus with different causes is a question that should be answered through large scale randomized controlled studies.

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Section: Antipruritic Effects Of Pregabalin On Uremic Pruritusmentioning

confidence: 88%

Role of Pregabalin in Management of Pruritus: A Literature Review

Foroutan

Nikvarz

2016

J Pharm Pharm Sci

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“…Treatment improved itch in 76% of patients after a 3-month treatment course (303). Pregabalin 50 mg every other day or 10 mg doxepin given daily for 4 weeks in patients with CKD-associated pruritus led to a significant improvement of pruritus in both groups, but was significantly more effective in patients receiving pregabalin (304).…”

Section: Gabapentin and Pregabalinmentioning

confidence: 98%

“…Sertraline proved effective in cholestatic pruritus both in adults (322) and children (323), as well as in CKD-associated pruritus (324,325). In a recent double-blind RCT among 50 haemodialysis patients, sertraline was shown to be effective in reducing uremic pruritus (326), while Doxepin also showed positive effects in 7 patients (304). Doxepin may be administered in a dose from 25-50 mg/day.…”

Section: Gabapentin and Pregabalinmentioning

confidence: 99%

European S2k Guideline on Chronic Pruritus

Weißhaar¹,

Szepietowski²,

Dalgard³

et al. 2019

Acta Derm Venerol

250

201

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ActaDV is a journal for clinical and experimental research in the field of dermatology and venereology and publishes highquality papers in English dealing with new observations on basic dermatological and venereological research, as well as clinical investigations. Each volume also features a number of review articles in special areas, as well as Correspondence to the Editor to stimulate debate. New books are also reviewed. The journal has rapid publication times.

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“…brachioradial pruritus or notalgia paraesthetica) (40)(41)(42)(43)(44)(45). The other frequently prescribed antidepressants, doxepin (29.7%), mirtazapine (12.9%) and paroxetine (11.9%), have been described more frequently, mostly for paraneoplastic pruritus, uremic pruritus or pruritus of unknown origin (21,23,24,28,(46)(47)(48)(49)(50), and were recommended in guidelines for various forms of CP not responsive to conventional treatment options (2,9,51). This discrepancy could be explained as amitriptyline is an established pharmacological intervention for neuropathic pain (52), and is therefore well known by most dermatologists.…”

Section: Discussionmentioning

confidence: 99%

Use of Systemic Treatment in Patients with Chronic Pruritus: A Survey of Dermatologists in the Netherlands

Kouwenhoven

Kerkhof²,

Kamsteeg³

2019

Acta Derm Venerol

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This is an open access article under the CC BY-NC license. www.medicaljournals.se/acta Acta Derm Venereol 2019; 99: 304-308 304 SIGNIFICANCE This study analysed the prescription of systemic treatment by dermatologists in patients with chronic itch. Overall, 6 out of 10 dermatologists prescribed antidepressants or gaba pentinoids, of which, antidepressants were prescribed most frequently. Reasons not to prescribe systemic treat ment included lack of knowledge or experience, risk of side effects, and lack of available evidence. Only a minority of the clinicians surveyed felt comfortable prescribing these drugs; therefore, we recommend more education on ef fective and safe dosing.Treatment of chronic pruritus can be a challenge for clinicians. Several systemic treatments have been suggested to reduce itch, such as gabapentinoids and antidepressants. The aim of this study was to assess the current practice of dermatologists regarding systemic treatment in patients with chronic pruritus, and to identify possible barriers in the prescription of these treatments. An online survey was sent to all dermatologists and dermatology residents in the Netherlands between July 2017 and April 2018. A total of 193 physi cians completed the questionnaire (response rate 27.0%). Overall, 61.7% prescribed gabapentinoids or antidepressants in patients with chronic pruritus. Amitriptyline was prescribed most frequently, followed by gabapentin, doxepin and mirtazapine. Reasons not to prescribe systemic treatment included lack of knowledge or experience, risk of side-effects, and lack of available evidence. As only a minority of respondents felt comfortable prescribing these drugs, more education on effective and safe dosing is needed. ActaDV ActaDV Advances in dermatology and venereologyActa Dermato-Venereologica 305 Systemic treatment for chronic pruritus Acta Derm Venereol 2019 ActaDV ActaDV Advances in dermatology and venereology Acta Dermato-Venereologica T. A. Kouwenhoven et al. 306

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Comparison of pregabalin with doxepin in the management of uremic pruritus: a randomized single blind clinical trial

Cited by 53 publications

References 26 publications

Role of Pregabalin in Management of Pruritus: A Literature Review

Role of Pregabalin in Management of Pruritus: A Literature Review

European S2k Guideline on Chronic Pruritus

Use of Systemic Treatment in Patients with Chronic Pruritus: A Survey of Dermatologists in the Netherlands

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