Gabapentin for Pruritus in Palliative care

Anand, Sheeba

doi:10.1177/1049909112445464

Cited by 22 publications

(14 citation statements)

References 43 publications

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“…The pathophysiology of scalp pruritus can be explained using 4 major mechanisms, namely, prurioreceptive, neuropathic, neurogenic, and psychogenic, which could promote more than a single mechanism [18, 19]. Prurioreceptive pruritus occurs when the itch is initiated within the skin by various inflammatory dermatological conditions that trigger the neurological pathway in the free nerve endings and then received by the brain through the unmyelinated C fibers along the contralateral spinothalamic tract.…”

Section: Pathophysiologymentioning

confidence: 99%

Scalp Pruritus: Review of the Pathogenesis, Diagnosis, and Management

Rattanakaemakorn

Suchonwanit

2019

BioMed Research International

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Scalp pruritus is a frequent problem encountered in dermatological practice. This disorder is caused by various underlying diseases and is a diagnostic and therapeutic challenge. Scalp pruritus may be localized to the scalp or extended to other body areas. It is sometimes not only associated with skin diseases or specific skin changes, but also associated with lesions secondary to rubbing or scratching. Moreover, scalp pruritus may be difficult to diagnose and manage and may have a great impact on the quality of life of patients. It can be classified as dermatologic, neuropathic, systemic, and psychogenic scalp pruritus based on the potential underlying disease. A thorough evaluation of patients presenting with scalp pruritus is important. Taking history and performing physical examination and further investigations are essential for diagnosis. Therapeutic strategy comprises removal of the aggravating factors and appropriate treatment of the underlying condition. All treatments should be performed considering an individual approach. This review article focuses on the understanding of the pathophysiology and the diagnostic and therapeutic management of scalp pruritus.

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Section: Pathophysiologymentioning

confidence: 99%

Scalp Pruritus: Review of the Pathogenesis, Diagnosis, and Management

Rattanakaemakorn

Suchonwanit

2019

BioMed Research International

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“…44 Further upstream, modulation of excitatory neurotransmitters with gabapentin can change itch perception through afferent neuron signal transmission and central hypersensitivity. 45 Of the topical treatments reviewed, capsaicin has the most evidence supporting its use in BRP. While the only RCT on topical capsaicin cream demonstrated no significant improvement in pruritus versus placebo, DISCUSSION difficulty blinding capsaicin's burning sensation may have limited study quality.…”

Section: Physical Therapymentioning

confidence: 99%

“…Gabapentin inhibits calcium ion channels on afferent neurons thus preventing excitatory neurotransmitter release. 45 Evidence for gabapentin's use in BRP is low given the lack of RCTs and prospective studies. While anecdotally, it seems to be an effective medication, high doses are required to provide symptomatic relief.…”

Section: Physical Therapymentioning

confidence: 99%

Treatment of Brachioradial Pruritus: A Systematic Review

2019

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Importance: Brachioradial pruritus (BRP) is a poorly understood disease and can severely impact quality of life. However, there is currently no clear treatment. Objective: To identify effective behavioral, topical, oral, and invasive treatment options for BRP, and to discuss the quality of the data currently found in the literature. Evidence Review: The PubMed and CINAHL databases were systematically reviewed for articles from 1968 to the present containing search terms “brachioradial OR solar OR forearm AND pruritus OR itching.” Results were narrowed to articles written in English, focusing specifically on BRP, and that stated precise treatment modalities. Evidence quality was determined based on the study type. Findings: Thirty-six articles discussing treatments for BRP are included in this review with a total 399 patients. Six studies (n=68) report on the efficacy of capsaicin cream, eight studies (n=26) on oral gabapentin 300 mg daily to six times daily and four studies (n=98) on sun protection. The remaining articles comprise of low-quality, small-scale studies on further oral medications, physical therapy, minimally-invasive procedures, and surgery. Conclusions and Relevance: Low-quality evidence supports the use of sun protection, topical capsaicin, or oral gabapentin as effective therapeutic modalities for BRP. Clinicians should be aware of possible underlying cervical spine pathology and include thorough imaging as part of BRP work-up. Further high-quality studies on BRP treatments would help elucidate clear management for this disorder.

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“…Gabapentin, due to its effect of increasing nociceptive threshold, had been recommended as a potential treatment for cholestatic pruritus. 77 A randomized, double-blind, placebo-controlled trial of 16 patients with cholestatic pruritus treated with 4 weeks of gabapentin failed to show any significant therapeutic advantage over placebo. 78 Phototherapy.…”

Section: Management Of Itch In Pbcmentioning

confidence: 99%

Novel strategies and therapeutic options for the management of primary biliary cholangitis

Khanna

Jones

2017

Therap Adv Gastroenterol

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Primary biliary cholangitis (PBC) is a chronic autoimmune liver disease. It has a varied course of progression ranging from being completely asymptomatic to aggressive disease leading to cirrhosis and resulting in liver transplantation. In addition, symptoms can be debilitating and can have a major impact on quality of life. For decades, there was only one anti-cholestatic agent available to target this disease and that was only effective in around half of patients, with little or no effect on symptoms. With increasing understanding of the pathogenic mechanisms of PBC and potential targets for drug treatment, pharmaceutical companies have shown a greater interest in this rare disease. A large number of novel therapeutic molecules have been developed and are currently being evaluated. In this review article all the novel molecules in use and in trials targeting cholestasis and symptoms in PBC are discussed.

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Gabapentin for Pruritus in Palliative care

Cited by 22 publications

References 43 publications

Scalp Pruritus: Review of the Pathogenesis, Diagnosis, and Management

Scalp Pruritus: Review of the Pathogenesis, Diagnosis, and Management

Treatment of Brachioradial Pruritus: A Systematic Review

Novel strategies and therapeutic options for the management of primary biliary cholangitis

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