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Oral antidepressants in patients with chronic pruritus
Chronic pruritus is a common skin symptom with marked impact on quality of life. Adequate treatment can be challenging for clinicians, demanding the exploration of new treatment options such as oral antidepressants.
The results of a systematic review evaluating the use of oral antidepressants in chronic pruritus were recently published in the Journal of the American Academy of Dermatology.
In the review, the PubMed, EMBASE, Cochrane, and Web of Science databases were searched. Studies providing original data on the efficacy of oral antidepressants in patients with chronic pruritus were included. A total of 35 studies evaluating the oral use of fluoxetine, fluvoxamine, paroxetine, sertraline, amitriptyline, nortriptyline, doxepin, and mirtazapine were included.
The majority of included articles showed a marked improvement of pruritus during treatment with oral antidepressants.
The results of the review surmised that oral antidepressants should be considered in patients with chronic pruritus that is unresponsive to topical treatment and oral antihistamines, particularly in patients with uremic pruritus, cholestatic pruritus, or paraneoplastic pruritus. However, more evidence based on randomised-controlled trials is required.
Use of oral antidepressants in patients with chronic pruritus: A systematic review. Kouwenhoven, Tessa A. et al. Journal of the American Academy of Dermatology , Volume 77 , Issue 6 , 1068 – 1073.e7
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