Long-term efficacy of sertraline as a treatment for cholestatic pruritus in patients with primary biliary cirrhosis

Abstract

Sertraline use is associated with an improvement in cholestatic pruritus. This novel observation implies that serotonergic fibers are important in regulating the perception of itch.

The pruritus of cholestasis

“…In a retrospective review, the use of sertraline (75 mg per day), a serotonin re-uptake inhibitor, was reported to be associated with improvement of pruritus in a small group of patients with PBC, who had recorded the perception of pruritus in their personal diaries as part of their participation in a clinical trial [116]. Any relationship between the reported effect of sertraline on pruritus and on mood is unknown at present.…”

Psychopharmakatherapie bei Pruritus

“…Tab. 1, [21]). In einer Dosisfindungsstudie zur Therapie mit Sertralin bei 21 Patienten mit Lebererkrankungen wurde zunächst eine offene Anwendung durchgeführt [22].…”

“…Nur wenige dieser Studien untersuchten die Beschwerdesymptomatik gezielt mithilfe von visuellen Analogskalen oder evalulierten Fragebögen [17,21,22,23]. Ferner wurde der Großteil der Studien nicht placebokontrolliert durchgeführt.…”

The Management of Hospitalized Patients with Cirrhosis: The Mount Sinai Experience and a Guide for Hospitalists

“…A trial of cholestyramine can be attempted although the drug should be administered several hours apart from other medications to prevent its interference with their absorption. Alternative agents that have been studied to treat pruritus include sertraline, a serotonin reuptake inhibitor that has been shown to moderately improve pruritus in cholestatic patients [29,30]. Other agents that have been studied include rifampicin and the opioid receptor antagonists naltrexone and naloxone [31].…”