Pruritus in children

Leung, Alexander K. C.; Wong, B. E.; Chan, Paul Y. H.; Cho, Helen Y.h.

doi:10.1177/146642409811800513

Cited by 13 publications

(2 citation statements)

References 16 publications

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“…Down-regulation of 5-HT 3 receptors, if confirmed in human studies, may be the key to understanding the antipruritic effect of paroxetine. 23 At the moment, we consider two hypotheses that may explain paroxetine's antipruritic activity. Chronic paroxetine therapy may modify central opioid receptors 24 involved in processing of itch signals.…”

Section: Discussionmentioning

confidence: 99%

Paroxetine in the treatment of severe non-dermatological pruritus: a randomized, controlled trial

Żylicz

Krajnik

Sorge

et al. 2003

Journal of Pain and Symptom Management

183

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Severe pruritus may be an idiopathic phenomenon or associated with advanced systemic disease. It is one of the most distressing and difficult to treat symptoms. Uncontrolled studies have suggested that, in patients experiencing severe pruritus, paroxetine appeared to have a rapid anti-pruritic effect. This study was a prospective double-blind, randomized within patient comparison of paroxetine and placebo. The intensity of pruritus was measured subjectively with a numerical analogue scale. The primary endpoint of the trial was the mean pruritus score, measured for seven days after randomization and after cross-over. The secondary endpoint was individual global response to the treatment. Response was defined as at least 50% reduction of intensity of pruritus in the last three days of the treatment period vs. baseline. Adverse effects and patient satisfaction and preferences were also recorded. Twenty-six patients were included in the study; 17 of them had solid tumors, 4 had hematological malignancies and 5 had various nonmalignant or idiopathic conditions. Eight patients had drug-induced pruritus (none opioid-induced), 7 patients had paraneoplastic pruritus and 3 had cholestatic pruritus. After a run-in period, patients were randomly assigned to treatment with 20 mg paroxetine or placebo. The crossover took place after 7 days. Two patients discontinued treatment because of adverse effects of paroxetine. Twenty-four patients treated with paroxetine had lower pruritus intensity scores over the 7 treatment periods (mean+/-SE=5.2+/-0.32) as compared to placebo (mean+/-SE=6.0+/-0.32). Mean difference between placebo and paroxetine was 0.78 (95% CI=0.37-1.19). Nine of twenty-four patients (37.5%) fulfilled criteria of response. The onset of anti-pruritic action was observed usually after 2-3 days, irrespective of the order of treatment. The outcome of this study indicates that paroxetine is effective in the treatment of severe pruritus of non-dermatological origin.

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Section: Discussionmentioning

confidence: 99%

Paroxetine in the treatment of severe non-dermatological pruritus: a randomized, controlled trial

Żylicz

Krajnik

Sorge

et al. 2003

Journal of Pain and Symptom Management

183

View full text Add to dashboard Cite

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“…Because pruritis can be worse at night, oral histamines have been beneficial at bedtime for their sedative properties in patients experiencing symptoms, and can be used as a short-term adjuvant to topical therapy (Kristal & Klein, 2000). The first generation antihistamines, hydroxyzine, diphenhydramine, and cyproheptadine all have sedative effects, but it is shown hydroxyzine to be more effective than the latter (Denman, 1986;Leung, et al 1998). Newer generation antihistamines ceterizine, loratadine, and fexofenadine may not be beneficial since they lack the sedating properties of the first generation antihistamines.…”

Section: Antihistaminesmentioning

confidence: 99%