Role of Pregabalin in Management of Pruritus: A Literature Review

Abstract

-Purpose. Pruritus can be one of the distressing symptoms of many dermatologic, systemic, neurologic or psychiatric disorders. In each case, the origin of itch is in the skin and/or the nervous system. Involvement of the nervous system causes neurogenic, psychogenic or neuropathic itch. Itch sensation is transferred to the central nervous system via unmyelinated C-type nerve fibers, and many mediators and receptors engage in the its induction and transmission. Also it has been demonstrated that there are similarities and interactions between neurotransmitters and pathways of pain and itch sensation. Hence, effective drugs in reducing the neuropathic pain such as pregabalin have been studied and used in the management of different itchy conditions. In this narrative review we considered the available published papers dealing with the antipruritic effects of pregabalin. Results of studies conducted in uremic patients show that pregabalin is an effective option in reducing uremic pruritus especially in those who have not responded to antihistamines and topical moisturizers. Data about the effects of pregabalin on other itchy conditions are very limited; however results of the available studies show beneficial effects of this drug in burn patients with more than 5% involvement of the total body surface area, in prurigo nodularis, and in chronic and idiopathic itch. One considerable issue is that the therapeutic effects of pregabalin on uremic pruritus and post burn itch may appear more rapidly than its effects in the other conditions (1-2 weeks vs > 4 weeks). The most reported adverse effects of pregabalin are sedation, dizziness and drowsiness. Whether pregablin can be unequivocally considered as an effective and reasonable choice in the management of pruritus with different causes is a question that should be answered through large scale randomized controlled studies.

Skilled reaching deterioration contralateral to cervical hemicontusion in rats is reversed by pregabalin treatment conditional upon its early administration

“…Early PGB treatment significantly reduced the prevalence of peri-incisional scratching, in-line with known effects of PGB on postoperative pain 4 and pruritus. 9,17…”

Prurito crónico

“…Los estudios que han evaluado el uso de estos agentes en el manejo del prurito crónico son muy limitados en el tamaño de la muestra y en el diseño, sin embargo, se sugiere que tienen gran utilidad en el manejo del prurito de origen neuropático como el caso del prurito posherpético, el braquiorradial y el nodular. 67 Algunos estudios también han sugerido su uso en el prurito de origen urémico. 68,69 • Antidepresivos: los medicamentos antidepresivos son considerados agentes modifi cadores del umbral de prurito, gracias a su acción farmacológica sobre la histamina y la serotonina.…”

Pregabalin administration and withdrawal affect testicular structure and functions in rats

“…The broad therapeutic effects of PG such as reducing neuropathic pain and anxiety and controlling epilepsy came from its ability to reduce the release of several excitatory neurotransmitters (like substance P and glutamate) and peptides like calcitonin gene‐related peptide (Foroutan & Nikvarz, 2016).…”