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Published online before print November 8, 2007, 10.1097/PSY.0b013e3181572799
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Psychosomatic Medicine 69:970-978 (2007)
© 2007 American Psychosomatic Society

ORIGINAL ARTICLES

Psychiatric Medications for the Treatment of Pruritus

Richard J. Shaw, MB, BS, Shaili Dayal, MB, BS, Julie Good, MD, Anna L. Bruckner, MD and Shashank V. Joshi, MD

From the Department of Psychiatry and Behavioral Sciences (R.J.S., S.D., S.V.J.) and Department of Pediatrics (J.G., A.L.B.), Stanford University School of Medicine, and Lucile Packard Children's Hospital, Palo Alto, California.

Address correspondence and reprint requests to Richard Shaw, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Palo Alto, CA 94305-5719.

Objectives: To review the use of psychiatric medications in the treatment of pruritus.

Methods: A literature review was conducted using the key words pruritus, psychiatric, and treatment.

Results: Three categories of pruritus are described: dermatologic, systemic, and psychogenic. Peripheral and central nervous system mechanisms of pruritus are reviewed. Conventional dermatologic treatments for pruritus are contrasted with some of the common psychopharmacologic treatment modalities that include anxiolytic, antidepressant, and antipsychotic agents. A treatment algorithm is offered to help guide the treatment of patients with pruritus.

Conclusions: Psychiatric medications have been used successfully in the treatment of pruritus that is associated with both psychocutaneous and systemic disorders, which are resistant to conventional treatment.

Key Words: pruritus • psychopharmacology • treatment • psychocutaneous

Abbreviations: 5HT = hydroxytryptamine; PGE2 = prostaglandin E2; SSRI = selective serotonin reuptake inhibitor; TCA = tricyclic antidepressant.






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