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Other effective therapies for neuropathic pruritus include gabapentin, antidepressants such as sertraline or doxepin, or opioid receptor agonist/antagonists such as naltrexone or butorphanol. Conclusions and RelevanceChronic pruritus can adversely affect quality of life and can be categorized into inflammatory, neuropathic, or a combined etiology. Gabapentin and pregabalin are safe and efficacious options to treat older adults with chronic pruritus. Prior to gabapentinoid initiation, the patient should be screened for: history of kidney disease; COPD or other lung disorders; current opioid medication use; history of falls, lightheadedness, or vertigo; history of mood disorders, including Evidence from 27 trials shows significant therapeutic value of the novel antiepileptic drugs pregabalin and gabapentin for pruritus, with a favorable safety profile. Background: Chronic pruritus is frequently seen in daily dermatological practice and is associated with marked impact on quality of life. Research on the use of gabapentin and oral antidepressants in daily dermatological practice is scarce. The findings from original sources published to date to evaluate the use of gabapentin and pregabalin as antipruritic agents are explored. They are found to be promising alternative treatments for the relief of several forms of chronic pruritus, particularly uremic pruritus and neuropathic or neurogenic itch, in patients who fail conservative Although the effect on pruritus after initiation of gabapentin or antidepressants may appear modest, it can be of meaningful significance at the individual patient level, and therefore both gabapentin and antidepressants should be considered as a therapeutic option in chronic pruritus unresponsive to first-line treatment options. Multiple studies have demonstrated that gabapentin and pregabalin are effective for several forms of pruritus, in particular uremic pruritus and that of neural origin. Gabapentin and pregabalin are promising therapeutic options for pruritus refractory to conventional treatment. For chronic pruritus, initial dosing of 300mg/d and can be increased to 1200mg three times per day. 3 Should be tapered gradually if discontinuing medication to avoid withdrawal symptoms such as seizures. 4 The exact antipruritic mechanism is unknown, but gabapentin has been demonstrated to be effective particularly in the treatment of neuropathic pruritus such as brachioradial pruritus. Furthermore, a significant efficacy has been reported in uremic pruritus 45 . The exact antipruritic mechanism is unknown, but gabapentin has been demonstrated to be effective particularly in the treatment of neuropathic pruritus such as brachioradial pruritus. Furthermore, a significant efficacy has been reported in uremic pruritus 45 . Pruritus is the sensation of itching. Although large-scale epidemiologic data on prevalence are limited, pruritus is a common symptom encountered in primary care. 1, 2 The etiology of pruritus is Keywords: Chronic pruritus; Gabapentin; Gabapentinoid; Itch; Older adult; Pregabalin Key Summary Points Gabapentin and pregabalin are safe and efficacious options to treat older adults with chronic pruritus. Prior to gabapentinoid initiation, the patient should be screened for: history of kidney disease; COPD or other lung Gabapentin and pregabalin are agonists of γ-amino butyric acid that effectively reduce itch likely through their role in neural modulation. 32 Although initially developed for the treatment of chronic pain syndromes such as diabetic neuropathy, these drugs have been reported to help treat various forms of itch, including neuropathic itch (ie the use of gabapentin and pregabalin as antipruritic agents are explored. They are found to be promising alternative treatments for the relief of several forms of chronic pruritus, particularly uremic pruritus and neuropathic or neurogenic itch, in patients who fail conservative therapies. (J Am Acad Dermatol 2016;75:619-25.) In the present study, the use of oral gabapentin 300 mg a day for the treatment of itching caused by NP showed to be efficient and led to a significant improvement in rates of itching intensity as assessed by the VAS. A case study involving five patients with chronic refractory vulvar pruritus showed that naltrexone 50 mg daily for three weeks reduced all patients’ itch (Böttcher B, Wildt L. Eur J Obstet Gynecol Reprod Biol. 2014;174:115-116). Three months after stopping naltrexone, “All patients were symptom-free,” Dr. Elmariah says.
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